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WHY DO STUDENTS CHOOSE TO STUDY

TRADITIONAL CHINESE MEDICINE AT VICTORIA

UNIVERSITY? AN ANALYSIS OF THE COURSE IN TCM

AND ITS STUDENTS

LIBRARY •

A THESIS

SUBMITTED TO THE SCHOOL OF HEALTH

SCIENCES,

VICTORIA UNIVERSITY

BY

VIVIENNE J. WILLIAMS

IN FULFILLMENT OF THE REQUIREMENTS FOR THE

DEGREE OF MASTER OF HEALTH SCIENCE BY

COURSEWORK.

FEBRUARY 2002.

Vivienne J. Wi l l iams 3047674. Master O f Health Science-2002

WER THESIS 610.951 WIL 30001007530407 Williams, Vivienne J Why do students choose to study traditional Chinese medicine at Victoria

CERTIFICATION.

I certify that this thesis has not already been submitted to

any other institution for any degree,

nor is it part of candidature for any other degree.

I also certify that I and that have written this thesis

any help that I have received in its preparation, and all

sources used have been acknowledged.

Signature of student

Vivienne J. Williams 3047674. Master O f Health Science-2002 j j

ACKNOWLEDGEMENTS.

This is tlie final page to be written in this thesis and there have been

many occasions when I felt that I would never get to this stage. The fact

that it is at its completion stage is due to the encouragement and

support of a number of friends and colleagues.

I would like to acknowledge my supervisor Cameron Gosling for his

input into this thesis. I am indebted to my co-supervisor, Robyn Mills

and would like to thank for her continued encouragement and guidance.

I wish to thank her for her assistance as a "sounding board" for my

ideas and for guiding me through the process of putting these concepts

into words. I couldn't have done it without you!

On a personal note, I wish to thank my "teacher" Jean Berwick, for her

guidance through the demons of my past and to overcome the doubts

about completing this thesis.

For the daily emotional support, encouragement and for "just being

there" when I needed her, Philippa Gemmell, you have my biggest

thanks.

Finally, to the TCM students at Victoria University, many thanks for

revealing yourselves in my questionnaire and giving me the content of

this thesis.

Vivienne J. Wi l l iams 3047674. Master O f Health Science-2002 J i j

CONTENTS.

CERTIFICATE ii

ACKNOWLEDGEMENTS iii

LIST OF FIGURES vii

GLOSSARY OF TERMS ix

ABSTRACT xi

CHAPTER ONE

Background and Rationale 1

1.1. Introduction and History of Traditional Chinese Medicine (TCM) in

Australia 1

1.2. General Aims of the Research 5

CHAPTER TWO

2.0 Literature review 6

CHAPTER THREE

3.0. Introduction and Discussion 14

3.1. Research Questions 14

CHAPTER FOUR

4.0 Methodology 15

4.1. Apparatus. -The questionnaire 15

4.2. Demographic questions 15

4.3. Subjects 15

Viv ienne J. W i l l i ams 3047674. Master O f Health Science-2002 J y

4.4. Likert, Spearman, Mann Whitney and Categorical Scales 16

4.5. Educational Background 18

4.6. The TCM Course 18

4.7. Expectations of Practice 18

4.8. Open Ended Questions 18

4.9. Pilot Survey 18

4.10. Subjects, Procedure and Confidentiality 19

4.11. Response rate 19

CHAPTER FIVE

5.0. Results 21

5.1.Demographic breakdown 21

5.2. Subjects 21

CHAPTER SIX

6.0.Discussio n 50

6.1. Characteristics 50

6.2. Teaching and learning responses 57

6.3. Direct effects on students studying TCM 68

6.4. Responses to Qualitative Questions 73

6.5. Description of Passion for TCM 72

6.6. Practice Ideals 80

6.7. Why did participants choose Victoria University? 83

Viv ienne J. W i l l i ams 3047674. Master O f Health Science-2002

CHAPTER SEVEN

7.0. Conclusion 92

CHAPTER EIGHT

8.0. Future Research 96

8.1. Educational Direction Specific to TCM 97

APPENDICES 98

Appendix A:

Cover letter 98

Survey Form 99

REFERENCES 108

Vivienne J. Wil l iams 3047674. Master O f Health Science-2002 y j

LIST OF FIGURES.

Figure 5.2.1.

Figure 5.2.2.

Figure 5.2.3

Figure 5.2.4.

Figure 5.2.5.

Figure 5.2.6.

Figure 5.2.7.

Figure 5.2.8.

Figure 5.2.9.

Figure 5.2.10.

Figure 5.2.11.

Figure 5.2.12.

Figure 5.2.13.

Figure 5.2.14.

Figure 5.2.15.

Figure 5.2.16.

Figure 5.2.17.

Figure 5.2.18.

Figure 5.2.19.

Figure 5.2.20.

Figure 5.2.21.

Students who spoke another language and who had

IVIoved to Melbourne to commence the course. 22

Languages spoken by students. 22

Ethnic Diversity 23

Religious beliefs 24

Previous work in the health industry 25

Payment of HECS debt 26

Receiving Austudy allowance 27

Students working 27

Full time or part time work 28

Prior tertiary experience 29

Other tertiary locations 30

Other areas studied 31

Highest level of qualification 32

Immediate family having TOM 33

TCM practitioners in family 34

Importance of the length of time course existed 35

Importance of selection Interview 36

Importance of information sessions 36

Importance of knowing days on campus 37

Importance of facilities at Victoria University 38

Importance of location of campus 38

Viv ienne J. W i l l i ams 3047674. Master O f Health Science-2002 V l l

Figure 5.2.22. Importance of being taught Western Medical Science

and TCM theory simultaneously 39

Figure 5.2.23. Importance of lecturers being experienced

TCM practitioners 40

Figure 5.2.24. Importance of lectures being currently in clinical

practice. 40

Figure 5.2.25. Importance of clinical teachers being in private

practice. 41

Figure 5.2.26. Importance of clinical teachers not being academics 41

Figure 5.2.27. Importance of lecturers being recently published in

the area of TCM. 42

Figure 5.2.28. Importance of research by lecturers 43

Figure 5.2.29. Importance of lecturers being trained as teachers. 44

Figure 5.2.30. Importance of lectures being interactive. 44

Figure 5.2.31. Importance of lecturers being seen to practice what

they preach. 45

Figure 5.2.32. Importance of lecturers being seen to be politically

active in TCM. 46

Figure 5.2.33. Hours taught in the classroom. 47

Figure 5.2.34. Acupuncture versus herbal students 48

Viv ienne J. Wi l l i ams 3047674. Master O f Health Scienee-2002 v l i l

GLOSSARY OF TERMS

Definitions and Abbreviations:

Channels See Meridians

Ch'i See "Qi'

Enter: Equivalent national Tertiary Entrance rank. Used

for 1999 first year students.

H.P.U. The Health Practice unit is a purpose built clinic

situated at St Albans campus for students to

practice their clinical skills in

Mature age student; Applicants must be a minimum of 18 years of age

and have been out of full time schooling for at least

12 months. Mature age applicants are not required

to have completed a Year 12 qualification.

Meridians The channel or pathway through which Qi flows

through the body.

Questionnaire. Survey completed by participants for this research.

Vivienne J. Wil l iams 3047674. Master O f Health Science-2002 I X

Qi (or Ch'i) The life force of being which manifests as both

energy and matter and flows through the

meridians.

Survey. The questionnaire completed by students for this

research.

TER: Tertiary Entrance Rank. Rank expressed as a

percentage that compares all final year students in

Victoria. Used before 1999.

TCM student; Any person who is undertaking the Bachelor of

Health Science- Acupuncture or Chinese Herbal

Medicine at Victoria University

Viv ienne J. Wi l l i ams 3047674. Master O f Health Science-2002

ABSTRACT.

Victoria University, along with University of Technology Sydney and R.M.l.T in

Melbourne have been active in providing education at a tertiary level in

Traditional Chinese Medicine (TCM) in Australia since 1992. Victoria

University was the first university in Melbourne to offer training in both

acupuncture and Chinese herbs. The purpose of this study is to explore the

perceptions of students currently enrolled into the acupuncture and Chinese

herbal streams at Victoria University to gauge their analysis of the course, Its

structure, lectures and facilities available to them. The research was carried

out by means of a survey questionnaire and the data arising from this

methodology was subsequently analysed using a combination of quantitative

and qualitative techniques. The study found that there was a high degree of

agreement amongst participants about the course, its content and how it was

delivered. The participants had strong views about how they intended to use

their knowledge and how they were going to practice and with whom. Whilst

the research demonstrated trends and patterns amongst the participants,

there are recommendations for future research proposed in this thesis. The

major findings of this research were that students came from a great variety of

cultural backgrounds, were employed in some way throughout their training

and preferred to delay payment of their HECS debt. The research also found

that the participants held strong views on their lecturers, clinical experience of

TCM academics and lecture delivery. Other areas identified in the research

were that of stress levels amongst students studying Bioscience, the overall

workload of the course and their ideals about establishing a practice. It is

concluded from this research that staff employed in the School of Health

Sciences to teach in the TCM course be professional in their academic role,

innovative in the delivery of the material taught and sensitive to the pressures

experienced by students who undertake to study TCM. Students in this

research have indicated that the standing of the Traditional Chinese Medicine

course at Victoria University has a good reputation amongst them. It is

concluded that this reputation may be damaged by future course changes and

planning which are not cognisant of the areas highlighted by the students in

this research.

Viv ienne J. W i l l i ams 3047674. Master O f Health Science-2002 ^ J

CHAPTER ONE.

BACKGROUND AND RATIONALE

1.1. INTRODUCTION AND HISTORY OF TCM IN AUSTRALIA.

Traditional Chinese Medicine is a health system, dating back some 5000

years. It is a complete health system within itself; the practitioner practices a

"holistic" form of medicine, which is that of looking at the totality of the patient

and treating their body, mind, emotions and their spiritual dimensions.

(O'Connor & Bensky 1981, p 1, Maciocia. G. 1989, p.1, Lui. G. 1997. p.2,

Cheng. X.I990 p. 1)

The practice of acupuncture, which is one aspect of Chinese medicine, and is

the art of inserting very fine needles into acupuncture points, which are

situated on meridians, and which traverse the body. There are 365

acupuncture points and 12 meridians. These meridians are channels or

pathways through which Qi flows around the body. These acupuncture points

stimulate "Qi" or "Ch'i" within the body to restore good health, balance and

harmony. Qi is, in simplistic terms, best described as the body's "life force"

and the practitioner believes that an imbalance of Qi will cause disharmony

and therefore illness and disease within the body. (Maciocia. G. 1989. p. 13,

Ross. J. 1985. p. 13. Cheng. X.1990 p.2, Austin. M. 1974. P.2)

Chinese herbal medicine is another aspect of Chinese medicine; this is an

ingested form of healing. Herbs are used to "rebalance" the body's "Qi". There

are many hundreds of herbs and these are either boiled into a decoction and

drunk, or made into pills and powders and taken orally. (State Administration

of Traditional Chinese Medicine 1995, p. 87)

Vivienne J. Williams. 3047674. Master of Health Science-2002 \

Chinese medicine practitioners take into account diet, weather and living

environment, exercise, and spiritual wellbeing when diagnosing illness in a

patient. (Chinese Acupuncture and Moxibustion 1990 p.51, Austin 1974. P.85)

Chinese Medicine was introduced into Australia mainly from the Asian

countries of China, Korea, Vietnam and Japan, and in more recent times there

has been an influence from both Europe and the United States of America.

Chinese medicine entered Vietnam, Korea and Japan from mainland China

during the third century onwards (Hsu & Peacher 1977, p 87). In 962 AD. A

college of Oriental Medicine had been established in Korea and information

between China and Korea flowed freely. As a result of this interaction the

spread of Chinese medicine reached Japan and from 630 to 838 AD at least

thirteen official embassies were sent to China from the Japanese court

(Needham & Lu 1986, p265).

The spread of Traditional Chinese medicine from Asia to Europe and the rest

of the world came about over the centuries as a result travellers and

missionaries. However, it was in France in the nineteenth century that

acupuncture first gained a level of respect due to its usage by the medical

profession in Europe. During the same century it became sufficiently known

and utilised by some individuals in the medical profession in England

(Needham & Lu 1986, p 297).

Chinese medicine was first introduced into Australia via the early Chinese

migrants who arrived with the gold rush. Many of the workers on the gold

fields availed themselves of treatments from the practitioners there. Both

acupuncture and herbal preparations were used by these practitioners on the

men and women working in and around the gold fields.

Vivienne J. Williams. 3047674. Master of Health Science-2002

However, Chinese medicine has remained the preserve of the Asian, and

more so, the Chinese communities in Australia until the 1960's when its

popularity spread to the wider population.

The rise in the popularity of acupuncture amongst the wider Australian

population began during this time due in part to the promotion of Chinese

medicine by the Chinese government. The novelty of using acupuncture for

surgical analgesia or to assist in quitting smoking has gained media coverage.

Australians who wished to train in acupuncture undertook short courses in

China or Hong Kong, or correspondence courses offered by Colleges in

Europe or the United States. This was in preference to learning from

individual Chinese practitioners in Australia, which had been the traditional

method of TCM education. Since there was no government legislation

requiring a minimum level of knowledge for practice, there was a consequent

variation in levels of expertise amongst practitioners (Ryan. 1995, p5).

There have been many approaches to both Federal and State governments

this century in Australia with regards to the regulation and registration of

Traditional Chinese medicine. Chinese herbalist in the gold mining areas of

Victoria made the first attempts for regulation over 100 years ago. There have

been many reviews into Chinese medicine in the 1970's, 1980's and finally in

the 1990's. The NH&MRC carried out the first reports in the 1970's and 80's

with an outcome that the profession was not cohesive enough, too

fragmented and undisciplined to be regulated. (NH&MRC 1974 and NH&MRC

1988 & 1989). It was not until Bensoussan & Myers in 1996 published their

findings in "Towards a Safer Choice" that the issue of regulation finally

became a reality. Legislation was passed in the Victorian Government on 7""

Vivienne J. Williams. 3047674. Master of Health Science-2002

May 2000, making way for the registration and restriction of title for

practitioners of Cliinese IVledicine.

Training in Traditional Chinese Medicine (TCM) was established in China at

the tertiary level in 1956 with government accreditation and financial support

from the Peoples Republic of China (Bensoussan & Myers, 1996, p.151). It

was not until 1992 that Victoria University introduced a Bachelor of Health

Science-Acupuncture and in 1996 Bachelor of Health Science- Chinese

Herbal Medicine, into the School of Health Sciences. Victoria University was

the first university in Australia, or in the English-speaking world, to offer an

undergraduate programme in Traditional Chinese Medicine (TCM). However,

this was quickly followed by a course at R.M.l.T. Originally TCM was started

in private colleges and was later transferred to the university (Bensoussan &

Myers, 1996, p 159).

From 1992 to date there have been five cohorts of students who have

successfully graduated from Victoria University with a Bachelor in Health

Science in either acupuncture or Chinese Herbal medicine. These students

are made up of both male and female, school leavers and mature age

students and from all socio-economic backgrounds. Some students go on to

work in the area they have been trained in and others either take on other

study or work in an unrelated area.

During the time the course has been at Victoria University it has evolved and

progressed in such a way, creating a programme, which is an innovative,

interesting and challenging course for the students. This has been achieved

by course changes, which took place in 1997 and 2001.

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002

However, there has never been a comprehensive study carried out of all

students. The School of Health Sciences does not know why their students

choose to study at Victoria University or what they think of the course as they

progress though it. From time to time students are asked to give feedback as

to how they view the course they are enrolled in and in particular each subject

they undertake. However, this approach has its limitations and biases as well

as lacking the academic rigor of research.

1.2. GENERAL AIMS OF THE RESEARCH

The aim of this research was to analysis a comprehensive profile of students

who are currently enrolled in the Bachelor of Health Science-Acupuncture and

the students enrolled in the Bachelor of Health Science-Chinese Herbal

Medicine from year one to four. The profile included information regarding the

students and their family of origin. The research explored the expectations

students have of the course they are enrolled in, their preferences and

perceptions of the staff and the facilities available to them.

There is little research in the area of students studying TCM and of their

expectations of the course and of themselves when they have completed their

studies. This research aims to gain information from the students relating to

their expectations during the course, and at completion. This research has

focused on four specific areas, which will be specifically looked at throughout

this research. The demographics of the student TCM population, factors

influencing their choice of Victoria University, their expectations of the

lecturers and lectures and the students expectations of how they will work and

use their training at the end of their course.


CHAPTER TWO

2.0. LITERATURE REVIEW.

It is necessary to break the literature into sub categories. The first category is

in relation to Chinese Medicine and its history, and then its more recent

position within the Australian context, both politically and professionally. The

next category looks at education generally, then more specifically linking the

connection to particular questions in the survey with expertise in areas of

teaching and learning.

The primary aim of the literature search is to ascertain whether a research

such as this one, had been undertaken before. From the search to date it

appears that there have been attempts incorporating similar aspects of this

research such as Ryan 1995 who undertook a similar project as part of his

Masters of Education. However, it appears that this research is original in its

concepts.

However, for an overall snapshot of what is happening in Chinese Medicine in

Australia, Bensoussan & Myers report in 1996, Towards a Safer Choice, gives

the most comprehensive coverage of education and practice of Chinese

Medicine in Australia today. However, the difficulty with this study is that a

relatively small section is devoted to education of Chinese Medicine in

Australia, and as such only looks at education from the side of the institutions

not from the side of the students. However, it does represent the best attempt

to give an accurate picture of which institutions are involved in teaching

Chinese Medicine in Australia, listing both universities and private colleges. It

also manages to give a breakdown of some of the components of these

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002 5

courses, which is relevant to this research and questions relating to how

students find studying TCM theory and practical classes over Bioscience

subjects. This is a relevant issue when students are looking at a course in

TCM and selecting which course structures are more suitable to them. See

Figure 5.2.22.

The topic of studying TCM and Bioscience has been contentious for some

time and there are varying views on this debate. However, when reading the

literature it can be seen that some authors try to explain the differences

between TCM theory and Bioscience as a way of analysing the differences in

Chinese medicine. (Kaptchuk 1986 Ch. 1) However, Bensoussan & Myers

report gives proportions of total load of the different categories offered in most

of the courses available in Australia. Some of the information gained from this

review was of use when viewing some of the characteristics of students

studying TCM. However this report falls short of being useful in gaining

perception from students about the course they are enrolled in.

There is a paucity of research relating to this topic of reviewing a particular

course and its students. It is intended that this research will address this

deficit.

This research project explores the many facets of a student's life, what the

students think of the course they are enrolled in, the staff and the facilities

available to them. Issues such as being a mature age student over a VCE

student and its potential difficulties associated with being an older student

such as relationships, work etc. Rolfe et al (1995) found a trend in other

medical related courses that showed mature age students were usually in the

minority. Gender has been raised as pertinent by Folgeman VanderZwagg


(1981) and this will be explored to see if there is a significant difference in the

number of female to male students and the percentage of either gender

completing the course. Folgeman VanderZwagg (1981) found that there was

indeed a higher attrition rate amongst female students in comparison with

male students. The current research did not explore the reasons why this was

so, and it could be postulated that this was perhaps related to any one area

such as workload, academic requirements, passion for TCM or that they were

given the wrong information about choice of course.

Victoria University's own strategic plan suggests that with the location of many

of the campuses within the western region of Melbourne that ethnic diversity

is encouraged and even expected within the student population. However,

from the strategic plan it is not possible to ascertain whether students moved

into the area for the course. Willoughby, Arnold and Calkins (1981) compared

students from difference urban and non-urban backgrounds and found there

is no difference academically. From the literature it was shown that the

University has placed a great emphasis on ethnicity and good teaching and

this research will endeavour to show whether or not this is in fact so, at a

"grass-roots" level.

According to the Australian Bureau of Statistics (1998) report in 1997 there

were 659,000 students enrolled into undergraduate and postgraduate courses

in universities. According to Bensoussan and Myers (1996) the number of

students studying TCM are approximately 1,000 in any given year. The

School of Health Sciences enrols approximately 80 students each year into

Chinese Medicine, which is approximately a quarter of the 386 full time

students catered for by the three university courses presently offering course


in TCM, Bensoussan and Myers (1996). This has come a long way since the

IVIedicare Benefits review in 1986 when it showed that there was no university

offering training in TCIVl (pi 17).

Of particular interest to this study is why do students decide on a career in

TCM and perhaps more importantly why did they choose Victoria University to

study TCM. Did they have such a passion for the subject that they were drawn

to the course and moved to Melbourne to be able to complete the course and

did this passion and motivation change as they progressed through the

course? There appears to be no literature, which supports this question. The

cultural aspect of a family history of TCM practitioners was examined to see if

in fact this influences student's choices. Ryan (1995 p 107) suggests that in

fact maintaining motivation was ranked 10*'' out of 12, as barriers to studying

acupuncture. Do more women than men complete the course as suggested

by Ryan (1995), are they school leavers or mature age students and do the

mature age students already hold a first degree as suggested by Bensoussan

and Myers (1996). There are many who make claim that those students with

previous academic ability have a good predictor of success at medical

schools (Collins, White, and Kennedy 1995; Montague and Odds 1990;

Prywes 1970; Roessler, Lester Butler, Rankin and Collins 1978; Tomlinson,

Clack, Pettingale, Anderson, and Ryan 1997; Weiss, Lotan, Kendar and Ben-

Shakhar 1988). This theory is tested in this research.

Perhaps one of the closest studies into Chinese medicine and its students is

one conducted by Ryan in 1995 as part of his master's thesis at UTS. The

theme of his masters, "Educational ramifications of traditional acupuncture

paradigm in the Australian context" is divided into two sections. The first being

Vivienne J. Williams. 3047674. Master of Health Science-2002 9

a qualitative perspective of academics involved in teaching Chinese Medicine

in Australia, the second section is more quantitative based where he surveys

students perception about his hypothesis on education in Chinese Medicine in

Australia. It is hoped that this research will extended Ryan's work to include

student's perceptions on teaching and learning within the course, as well as

clinical perceptions and a section reviewing student's intentions after

completing their degree.

When asking students how they viewed their lecturers and their involvement

in their own profession politically and also including areas such as, research

in TCM, and clinical teaching in their teaching capacity, it appeared that this

arena of academia and research to be one of the areas, which were difficult to

maintain. In Lawson et al (1999) article about the "rise and rise" of academic

practice in Australia, they talk about supporting medical academics and the

difficulty with providing them with more time for professional development and

research. The difficulty with this study is of course that it relates to the medical

fraternity and the TCM fraternity has even fewer funds to support research

and academia. When considering the qualifications and expertise of the

lecturers the statement made in 1973 by the WHO, (p 14), that the

assumption that qualification in subject matter is equivalent to qualification for

teaching has been accepted for so long in higher education that an

educational research and development centre can anticipate some measure

of resistance to this aspect of its work. Continuing this trend of scrutinising

lecturers teaching skills, Warren-Pipe (1994 p 227,) states that there is no

requirement for people appointed to academic posts to have any formal

education in the process of teaching and examination. Warren-Pipes

Vivienne J. Williams. 3047674. Master of Health Science-2002 j Q

comments therefore have great significance when analysing participant's

perceptions of their teachers.

When students were asked about their levels of passion they felt by for the

subject, the only description found to support the concept for passion for a

career was by Macquarie (1995 p 290) as a very strong feeling about

something or in something. This is disappointing and it is hoped that this

research will go some way in addressing this deficit in the literature.

Further exploration of the literature is in relation to the expectations of

students after they have completed their degree and how, and whom they

would like to practice with. One of the difficulties, which graduates will have,

especially for those practising acupuncture, is the number of general

practitioners giving acupuncture treatments. Easthope et al (1999) talks about

the population in the United States, Canada, the Netherlands, the UK and

Australia, who are increasingly using medicines that are not part of the

conventional pharmacopoeia, and seeking therapies that are not taught in the

conventional medical undergraduate curriculum. In Australia one such

therapy, acupuncture, is of particular interest in that doctors use it as part of

their normal general practice use it. It is not part of the standard medical

curriculum in Australia, but it is recognised as a standard medical therapeutic

technique in that it attracts a Medicare rebate (as item 173) when a medical

practitioner performs it. Whilst this article gives details of the increase in the

number of doctors who perform acupuncture, it also, in inference, claims that

acupuncture is an established complementary medical practice. A fact, which

most new graduates, would have difficulty with when considering the

possibility of establishing a practise within the scope of a medical centre.

Vivienne J. Williams. 3047674. Master of Health Science-2002 \ ]

Whilst acupuncture treats many conditions it is worthy of note that Easthope

(1999) goes on to say that doctors are choosing acupuncture, are not doing

so for monetary reasons. For some it is now an established complementary

therapy, apparently chosen for clinical reasons. Easthope's research falls

short of giving details about the training of doctors who practise acupuncture,

their full understanding of the theory of TCM and the comments on monetary

reasons for using acupuncture have to be viewed with some cynicism.

Bensoussan (1999) Collins, White, and Kennedy (1995); Montague and Odds

(1990); Prywes (1970); Roessler, Lester Butler, Rankin and Collins (1978);

Tomlinson, Clack, Pettingale, Anderson, and Ryan (1997); Weiss, Lotan,

Kendar and Ben-Shakhar (1988). In their articles on complementary medicine

they go on to say generally, that when health consumers develop sickness

they do not consider actively whether their health care practitioner is "oozing

warm fuzzies", but rather, target what they believe to be the most effective

way to get better. His research shows that the consumer of health care will

use both complementary therapists and doctors when seeking the best

treatment for their health care. A fact, which may well influence students who

after completing their training in TCM seek a location to work from which, may

include many modalities. This type of location will support the "shopper" in

health care but also give a new graduate an opportunity to be exposed to a

variety of modalities. However, Bensoussan's research falls short of

demonstrating that the medical profession will recognise practitioners who are

trained in TCM as specialists in this area, but still places them in the "fringe"

area of medicine, still without scientific research to back up its use and

successes.

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002 j 2

In summarising the literature, the research of Bensoussan and Myers has

demonstrated how the TCM profession is educated, and what the different

teaching institutions are offering students wishing to learn Chinese medicine.

Collins, White, and Kennedy, (1995) Montague & Odds, (1990), Prywes,

(1970), Roessler, Lester Butler, Rankin and Collins, (1978) Tomlinson, Clack,

Pettingale, Anderson, and Ryan, (1997) Weiss, Lotan, Kendar and Ben-

Shakhar, (1988), have all given an indication about the academic ability of

students. Easthope et al (1999), have given their opinions on the trend of

patients seeking treatment for illness, which hitherto have not been

considered "conventional" by the medical profession. They also demonstrate

in further research a more recent trend within the medical professional ranks

of doctors now choosing acupuncture as a treatment within their own

practices. Ryan's research of the students at UTS in Sydney gives an insight

into some aspects of student life whilst studying TCM and Warren-Pipes

insights into the qualifications of tertiary lecturers. However, there is paucity in

regard to student's perceptions of lecturers, facilities, workloads, and passion

for their chosen subject and finally what students intend to do once they have

completed their training.

Therefore, this research project aims to give an insight into these areas, which

have hitherto been lacking in the current research material available, by

analysing a comprehensive survey of all aspects of a students life whilst

studying TCM.

Vivienne J. Williams. 3047674. Master of Health Science-2002 J 3

CHAPTER THREE

3.0. INTRODUCTION AND DICUSSION.

After students completed the questionnaire it became apparent that there

were a number of themes, which were becoming obvious from the responses.

These themes are the basis for the following research questions.

3.1. RESEARCH QUESTIONS

1. Do students value clinical experience in lecturers over research

achievements?

2. Does the length of time and the facilities of the course at Victoria

University influence students in deciding where they would study TOM?

3. Do most students, who complete their degree, have plans to work in

the profession they are trained in? It is hoped that this research will be

able to identify where students intend to practice and with whom.

4. Do students have a pre-existing interest in the culture of Eastern origin

that predisposes then to study TOM?

5. Do students from an Asian background have cultural influences, which

may be imposed on students to follow a family tradition working in

Traditional Chinese Medicine?

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002 j 4

CHAPTER FOUR.

4.0. METHODOLOGY

4.1. Apparatus-The questionnaire.

This research used a survey questionnaire, which was designed specifically

for this study. It contained a combination of qualitative and quantitative data.

The questionnaire had questions broken into four themes.

1) Demographic questions including educational background.

2) The TCM course including questions on facilities and lecturers.

3) The Expectations of practice after completing the course.

4) Open ended questions.

4.2. Demographic Questions.

Questions 1-15 refer to the demographic section of the questionnaire.

4.3. Subjects.

In this research the demographics of the students were explored including

their ethnic breakdown, previous education, religion, and what areas they

have studied before. In addition, their gender and whether they are single or

married and if they have children and whom they live with was also visited

Questions 1-15 relate to demographic information. These consisted of

questions about age, ethnicity, marital status and living arrangements.

Demographic data was broken down into age (school leavers and mature

age); gender (male and female); cultural background (European, Asian etc);

secondary schooling (private and public); language, and religion, with

students being asked to answer each questions with a yes or a no answer, or

a one word personal response.

Vivienne J. Williams. 3047674. Master of Health Science-2002 | 5

4.4. Likert, Spearman, Mann Whitney and Categorical Scales.

This research used, the Likert scale of 1 (disagree) to 5 (agree) for questions

37-45.

Question 46, used the Likert scale of 1 (Not important) to 5 (Highly

innportant).

Questions 47-61 the Likert scale of 1 (disagree) to 5 (agree) was used.

Questions 65-68 a categorical scale of 1 (no) to 3 (unsure) was used.

However, the limitations of using such a scale are evident when the sample

group place marks between the scales, indicating that they are not able to

decided between the categories. This observation is also made by Polgar &

Thomas (1995 p 132) when they list the advantages of using the Likert scale

as it allows the middle "undecided" responses and the disadvantages of using

the Likert scale as acquiescent responses mode.

Spearman's correlations were used to support the significance of the data

gathered from questions 44 and 46 (g), questions 69 and 46 (e) and question

69 and 46 (e).

Mann Whitney tests were run on question 46 and the relationship between the

acupuncture students and the herbal students and their responses to the

question relating to clinical practice and qualities expected from the lecturers

and the lectures, using sub questions, a) experience as a TCM practitioner, b)

that lecturers were currently in clinical practice, I) that the clinical teachers

were in private practice, and m) that the clinical teachers were not academics

the results are shown in simple percentage form in Figures 5.2.23, 5.2.24,

5.2.25 and 5.2.26.

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002 1 5

Mann Whitney tests were run on question 46 and the relationship between the

acupuncture students and the herbal students and their responses to the

question relating to clinical practice and qualities expected from the lecturers

and the lectures, using sub questions, a) experience as a TCM practitioner, b)

that lecturers were currently in clinical practice, I) that the clinical teachers

were in private practice, and m) that the clinical teachers were not academics

the results are shown in simple percentage form in Figures 5.2.23, 5.2.24,

5.2.25. and 5.2.26.

Mann Whitney tests were run on question 46 in relation to how the sample

surveyed view the importance of sub questions, c) that lecturers are recently

published in the area of TCM, f) that lecturers were currently involved in

research. Figure 5.2.27. and 5.2.28 shows the outcome of the test in simple

percentage graphs.

Spearman's Correlations

There was a significant correlation between whether the participant thought

that the number of hours taught in the classroom were adequate and the

perception that lecturers are trained as teachers, rs.=+.009,p<0.05.

There was a significant correlation between the acupuncture participants and

that lecturers should be up to date with computer based programmes,

rs.=+.008,p<0.05.

There was a significant correlation between the herbal participants and that

lecturers should be up to date with computer based programmes, h —

.008,p<0.05. However, these correlations are deemed to be very low.

Vivienne J. Williams. 3047674. Master of Health Science-2002 j 7

4.5. Educational Background

Questions 15-33 relate to the student's educational background. These

consisted of questions about VCE scores, where the students had previously

studied, how they are paying their HECS debt and whether they had studied

at a tertiary level prior to conning to Victoria University.

Questions 34-36 relate to whether the student had previous experience of

TCM, either personally or within the students' family.

4.6. The TCM Course

Questions 37-61 relate to specific questions about the TCM course the

student is enrolled into. These consist of questions about facilities at the

campus, perceptions of the lectures and whether the students found any

aspect of the course stressful.

4.7. Expectations of Practice.

Questions 64-68 relate to the expectations of the student at the end of the

course, their intentions in regards to working in TCM and in which settings

they hope to practice in.

4.8. Open Ended Questions.

Questions 63 and 71 are open-ended questions, giving students the

opportunity to expand on their beliefs about themselves and about the level of

passion they feel about TCM

4.9. Pilot Survey

The questionnaire was revised after a pilot survey was taken of 20 fourth year

students. The original survey form had 60 questions, however, after analysing

the data it appeared that there was difficulty with completing some of the

questions. In addition new questions were asked as it was apparent from the

Vivienne J. Williams. 3047674. Master of Health Science-2002 j g

completed questionnaires that the type of data required would not be gained

from the questions initially asked, so new or expanded, or more specific

questions were added.

4.10. Subjects, Procedure and Confidentiality

Formal questionnaires were handed to all students enrolled in the Bachelor of

Health Science-Acupuncture and Chinese Herbal Medicine at Victoria

University-St Albans campus, wishing to take part in this research project. The

procedure was conducted on a class-by-class basis and offered on a

voluntary basis only. Students were informed of the purpose of the

questionnaire and of the procedures adopted to ensure complete anonymity.

A questionnaire box was assigned for the purpose of a collection point and

students were asked to place their completed questionnaire into this box.

Data was collected from the participants by means of a survey, which has 71

questions. All information will remain confidential and is not subject to

personal analysis, but however, was evaluated as pooled data. All

questionnaires were assigned an alphanumerical coding and will be identified

only by this coding. Ethics committee approval was gained prior to

commencement of the questionnaire being handed to students to complete,

from the Faculty of Human Development Human Research Ethics Committee

at Victoria University. As per appendix A.

4.11. Response rate.

Questionnaires were given out to all students currently enrolled into the

Bachelor of Health Sciences-TCM at Victoria University and opportunities

were available for students to also collect questionnaires if they were not

present the day the questionnaires were given out in the classes. A total of 38

Viv ienne J. Wi l l iams. 3047674. Master of Health Science-2002 ] 9

questionnaires were completed and placed into the box. This represents a

response rate of approximately 30%.


CHAPTER FIVE.

5.0. RESULTS.

All data collected from the participants was entered into a computer

programme, SPSS for Windows. All data was recorded as a percentage or as

raw data and analysised using a Spearman or Mann Whitney format and

formulated into pie graphs or comparative percentage graphs.

5.1. Demographic breakdown.

Questions 1-15 related to the demographic breakdown of the students.

5.2. Subjects.

The sample population is representative of the population as all students

currently enrolled into the TCM programme at Victoria University come from

diverse backgrounds, ethnicity and religious beliefs, in fact a cross section of

the Australian population.

There were 9 males and 29 females ranging in age from 19 to 49 years, with

an average entry age of 21.1 years, 57.9% were married with 89.5% of those

who were married who did not have children. The sample showed that 52.6%

spoke another language as demonstrated in Figure 5.2.1. and that 28.9% had

moved to Melbourne for the commencement of the course in TCM.

It was evident that 55.3% were not VCE entrants, of those students who were,

39.5% were from state schools, as opposed to 31.6% from private schools

and 7.9% from TAPE institutions. These figures demonstrate that over half of

the prospective students have not come directly from high school and when

considering Figure 5.2.5. also indicates that approximately 40% of students

have worked previously in the health industry.


Figure 5.2.1.

Students who spoke another language

Students who had moved to Melbourne to commence course

LANGUAGE

The participants were asked to give information about the languages they

spoke and Figure 5.2.2. demonstrates the diversity of these languages.

Figure 5.2.2. Languages spoken by students.

Japanese

Viv ienne J. Wi l l iams. 3047674. Master of Health Sclence-2002 22

From the sample group it was found that the ethnic diversity was well

represented with in the TCM group, this is represented in Figure 5.2.3.

However, perhaps the diversity of groups is greater than anticipate.

Figure 5.2.3. Ethnic Diversity

Hungarian/Maltese

Anglo-Celtic

Vivienne J. Williams. 3047674 Master of Health Science-2002 23

This research has found that there is a great diversity within religious beliefs,

as shown in Figure 5.2.4.

Figure 5.2.4

Religious Beliefs.

Jewish

None


Only 39.5% had worked in an area of health prior to commencing the course

see Figure 5.2.5. with 36.8% having never experienced any form of TCM

before embarking on the course in TCM.

Figure 5.2.5.

Previous work in the health industry.

Not worked in hfelth

Vivienne J. Williams^ 3047674. Master of Health Science-2002 25

In Figure 5.2.6. it demonstrates student's payment of HECS fees, with 81.1%

of the sample surveyed deferring payment. However, Figures 5.2.7 and 5.2.8.

illustrate that 63.2% are receiving Austudy and that 71.1% of students also

worked whilst completing their studies.

Figure 5.2.6.

Payment of HECS debt.

40

30

20

10.

•=5

UPFRONT DEFFERED PARTPAYMENT

PAYMENT OF HECS DEBT

Viv ienne J. Wi l l iams. 3047674, Master of Health Science-2002 26

Figure 5.2.7. Receiving Austudy Allowance.

26

24

22

20

18

16

14 c 13 o 12

YES

AUSTUDY

Figure 5.2.8. Students working.

YES

WORKING 27

In Figure 5.2.9. it is observed that whilst 86.7% are working part time during

their course, it is also noted that 13.3% of students surveyed have a full time

job during their studies.

Figure 5.2.9. Full time or part time work.

30

20

10

FULLTIME PARTIME

WORKING FULL TIME OR PART TIME

Viv ienne J. Wi l l iams 3047674 Master of Health Science-2002 28

The survey sample showed that 55.3% of students had studied at a tertiary

level prior to coming to Victoria University and Figure 5.2.10. illustrates the

universities where students previously studied.

Figure 5.2.10.

Prior tertiary experience.

not attended a unive University of Wester

University of Melbou

Griffith University

RMIT

Monash University

Latrobe University

University of South

f / f Adelaide University

Overseas Universitie

Victoria University

Auckland University

University of Wester

Deakin University

Viv ienne J. Will iams^ 3047674. Master of Health Science-2002 29

The surveyed group showed that prior learning not only took place at

universities but at other types of institutions prior to their commencement of

studies at Victoria University. Figure 5.2.11. outlines the diversities.

Figure 5.2.11.

Other institutions previously studied at by participants.

C c. \ \

o/

PREVIOUSLY STUDIED AT

Viv ienne J Wi l l iams. 3047674. Master of Health Science-2002 30

In question 32, the surveyed group was asked which areas they had studied

in prior to commencing studied in TCM. The results are outlined in Figure

5.2.12.

Figure 5.2.12

Which subjects previously studied?

none

Massage

Computer programming

Shiatsu

ter Systems Eng

Hypnosis

Psychotherapy

Myotherapy

Biological Sciences

Family Therapy

Telecommunications

Hospitality

Art and Design

Psychology

Viv ienne J. Wi l l iams. 3047674, Master of Health Science-2002 31

Figure 5.2.13 outlines the highest level of qualification the surveyed group had

achieved prior to the commencement of their TCM studies at Victoria

University.

Figure 5.2.13.

Highest level of qualification.

Graduate Diploma

Bachelor-Degree

Associate Dipio

Diploma


Questions 35 and 36 relates to the experience of sample group either having

anyone in their immediate family, or themselves regularly see a TCM

practitioner for health reasons, and if there was anyone in their family who

was a practitioner of TCM. The results are outlined in Figures 5.2.14. and

5.2.15

Figure 5.2.14.

Immediate family having TCM treatments.

IMMEDIATE FAMILY HAVING TCM

ALL OF THEM GRANDPARENTS


Figure 5.2.15

TCM practitioners in family.

TCM PRACTITIONERS IN FAMILY

GRANPARENTS

Vivienne J. Williams. 3047674, Master of Health Science-2002 34

Question 37 relates to whether the sample group believed that the length of

time the course has been established is important in choosing an institution.

Figure 5.2.16.

Importance of length of time course has existed

DISAGREE SOMETIMES AGREE

MOSTLY DISAGREE MOSTLY AGREE

Question 38 and 39 relate to whether the sample group thought that there

should be a selection interview for the TCM course and whether they thought

that an information session on the TCM course after being selected and prior

to commencing the course would be helpful. The results are outlined in

Figures 5.2.17. and 5.2.18.


Figure 5.2.17.

Importance of a selection interview



As can be seen in Figure 5.2.17. most students agreed that a selection

interview was deemed to be very important.

Figure 5.2.18.

Importance of information sessions



Vivieiiiie J. uwNiidiiis. o u t / o / t . ivid&iei ui nediiii ouieilue-^uuz 36

Question 40 asked the sample group about knowing which days they were

required on campus was important to them prior to commencement of the

TCM course? The results are outlined in Figure 5.2.19.

Figure 5.2.19.

Importance of knowing which days required on campu

DISAGREE SOMETIMES AGREE MOSTLY DISAGREE MOSTLY AGREE

In questions 43 and 45 the survey sample was asked for their feedback on the

facilities available to them at Victoria University being adequate for TCM

training, and the location of the Victoria University campus being important in

making a choice of TCM courses. Figures 5.2.20. and 5.2.21. demonstrates

the responses.


Figure 5.2.20.

Importance of facilities at Victoria University



As can be seen in Figure 5.2.20. student did not always agree about the

importance of the facilities available to them.

Figure 5.2.21.

Importance of the location of campus




Figure 5.2.22. relates to question 42 where the survey group was asked if

they valued being taught western medical science and TCM theory at the

same time In the course as it enhanced their understanding.

Figure 5.2.22.

Student's perception

importance of being taught WMS & TCM theory simulatiously 60

50

40

30

20

c 10 CD 0

1 0 DISAGREE SOMETIMES MOSTLY AGREE AGREE

1 = strongly disagree, 5 strongly agree


Figure 5.2.23.

Importance of lectures being expereinced TCM practitioners 100

80

60

40

20

c

8

MOSTLY I M P O R T A N T HIGHLY I M P O R T A N T

As can be seen in Figure 5.2.23 students clearly stated that they thought it

was important that lecturers are experienced TCM practitioners.

Figure 5.2.24.

Importance of lecturers currently being in clinical practice.

SOME IMPORTANCE MOSTLY IMPORTANT

IMPORTANT HIGHLY IMPORTANT

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 40

Figure 5.2.25.

Importance that clinical teachers are in private practice 40

30

20

10

c (D 0

1 0 o NOT IMPORTANT IMPORTANT HIGHLY IMPORTANT


Figure 5.2.26.

Importance of clinical teachers not being academics

NOT IMPORTANT IMPORTANT HIGHLY IMPORTANT



Figure 5.2.27.

Importance of lecturers being recently published in the area of TCM

30




Figure 5.2.28.

c Q) O i— (D Q-

Importance of Reseach by lecturers



Question 46 asked the survey group a number of questions in relation to the

qualities of lectures and teaching within the TCM course, asking sub

questions g) the importance of such issues as lecturers being trained as

teachers, and h) that lectures were interactive. The results of these questions

are in Figures 5.2.29. and 5.2.30.

Vivienne J, Williams. 3047674. Master of Health Science-2002 43

Figure 5.2.29.

Importance of lecturers being trained as teachers



It can be seen from Figure 5.2.29. that students felt that it was highly

important that lecturers were trained as teachers.

Figure 5.2.30.

Importance of lectuers being interactive

SOME IMPORTANCE MOSTLY IMPORTANT IMPORTANT HIGHLY IMPORTANT


It can be seen that students felt that it was highly important that lectures were

interactive.

Participants were asked if it was important to them that their lecturers were

seen to practice what they preach and to be politically active within their

profession. The results are shown in Figures 5.2.31. and 5.2.32.

Figure 5.2.31.

Importance of lectuers being seen to practice what they preach

NOT IMPORTANT

HIGHLY IMPORTAf IT

It can be seen from Figure 5.2.31 that 50% of students stating that lecturers

were seen to practice what they preached.

Vivienne J. Williams. 3047674, Master of Health Science-2002 45

Figure 5.2.32.

Importance of lectures being politically active within TCM

HIGHLY IMPORTANT

MOSTLY IMPORT/ y(iT \

IMPORTANT

NOT IMPORTANT

SOME IMPORTANCE

As can be seen from Figure 5.2.32. the student's response showed that they

believed that there was some importance in lecturers being politically active

within the TCM profession.

The survey group was asked if they believed that the number of hours taught

in the classroom was adequate, Figure 5.2.33. As can be seen, most students

placed some importance on the number of hours taught in the classroom.

Vivienne J. Williams^ 3047674 Master of Health Science-2002 46

Figure 5.2.33.

Hours taught in classroom are adequate.

AGREE

DISAGREE

When analysing the data from this survey, one of the critical factors in looking

at the perception of the surveyed group is to ascertain if there is a difference

of opinion between the acupuncture students and the Chinese herbal students

who were survey. Figure 5.2.34. gives the break down of the two groups.

Vivienne J Williams 3047674 Master of Health Science-2002 47

Figure 5.2.34.

acupuncture herbal

ACUPUNCTURE VERSUS HERBAL STUDENTS

As can be seen from Figure 5.2.34. the total number of students who

participated in this research was equally divided between the acupuncture

students and the Chinese herbal students.


CHAPTER SIX

6.0. Discussion.

This comprehensive analysis of the course in TCM at Victoria University and

its students, set out to investigate the many facets of a TCM student. These

included such areas as the various demographics of the students, their

perceptions about the facilities, the teaching and learning component of their

training as well as the passion for TCM and their intentions of how they intend

to practice once they have completed their training. They survey results have

met these goals of this research. The aims and hypotheses have produced

results, which in some cases were expected, but there have also been some

unexpected results. The following discussion will give a critique of these

results.

The discussion section is divided into sections covering the different aspects

of the survey. Whilst the discussion will cover the many aspects of this survey

it is not expected to be exhaustive on the subject. However, whilst it does give

insight into the responses it also opens up many more questions for future

research.

6.1. Characteristics.

When looking at the characteristics of the participants it can be seen in Figure

5.2.34. that the same number of acupuncture students as herbal students

responded to the survey. This is important when looking at the total number of

students enrolled in TCM, there are at present two streams within the TCM

course, the acupuncture stream and the herbal stream. As the herbal stream

has not been established as long as the acupuncture stream, there are not

Viv ienne J. Wi l l iams. 3047674, Master of Health Science-2002 4 9

equal numbers in the two streams, so it could be assumed that there would be

a tendency for more acupuncture students to respond to the survey.

There were 24% males and 76% females. This goes against the medical

trend where 44% of vocational trainees are female, (Medical Training Review

Panel, 1999 page 22), and a similar course at UTS were 52% of students

were female (Ryan, 1995 p 105). Similarly, in other courses in Victoria

University there is a high percentage of females with 86% being female in the

Bachelor of Arts (Psychology) in the year 2000, and in 2001 in the Bachelor of

Science, (Clinical Science) 70% of the students were female. (Vic Uni

Management Information System 2001).

The ages ranged from 19 to 49 years, with 63% of students between 20 and

30 years of age, this is against the trend when looking at students at UTS

where only 36% of students came within this category. (Ryan, 1995 p. 105). It

can be seen that 57.9% were married, and that 89.5% who were married, did

not have children. The ability of students to be able to maintain both a full time

tertiary course and a relationship is possibly courageous and significant when

considering the amount of time required studying a course with its volume of

study and which challenges shifts in philosophical paradigms.

In line with the mission statement from Victoria University, to offer a university

education to all cultures and ethnic groups, the sample showed ethnic

diversity with many different cultures being identified. There were 52.6% who

spoke another language as demonstrated in Figure 5.2.2. which is slightly

lower than the trend set in the UTS course of 75% (Ryan, 1995 pi06). The

ethnicity of the survey group, illustrates that the TCM course, although with its

origins in Asia, attracts students from many cultures. However, it can be seen

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 5 Q

that the 47.4% of students come from a British/Anglo Saxon background,

which is significantly against the trend at UTS with 83.7%. There were fewer

than 20% of students coming from Asian countries, which is very much in line

with UTS at 14.13% (Ryan, 1995 p 106).

The survey indicated that 28.9% had moved to Melbourne for the

commencement of the course in TCM, this figure however, does not indicate

whether the student moved intrastate or interstate within Australia, or from

overseas. However, this would be expected, as the number of courses

available to students in Australia in TCM at a tertiary level is only three, with

two in Melbourne and one in Sydney.

The diversity of religious beliefs, as shown in Figure 5.2.4. indicates that the

majority of the survey group, 42.5%, has no particular religious beliefs.

However, of those who did indicate their religious beliefs, the largest single

identified group was the Catholic religion with 15%. The groups which most

align to TCM are the Daoist, Buddhist, and Universal religions. When the data

was collapsed to form a common group between these religions they equated

to 12.5% of the religious beliefs. This is of interest when noting the response

to question 54, which asks if their spiritual and philosophical ideals are

challenged within the course, only 20% responded that they were challenged.

From this we can perhaps postulate that when students are asked about

religion they do not equate these beliefs with their spiritual and philosophical

ideals. Another theory could be that students when exposed to Taoism and

Confucianism do not see these as religions but perhaps more of a way of life.

When asked the question as to where students took their VCE, 39.5% were

from state schools, as opposed to 31.6% from private schools and 7.9% from

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 5 j

TAPE institutions; it also appears that 55.3% were not VCE entrants. Tliis

figure is slightly lower than the trend set by UTS with 84.78% of their students

being mature age entrants. (Ryan, 1995 p 105). With a course, which attracts

a large number of mature age students, it is not surprising to find that 39.5%

had already worked in an area of health prior to commencing their TCM

training, which may have given them a basis for studying TCM. It is also, not

surprising to find that 15% had worked in the area of massage and 7.5% had

worked in the area of Shiatsu, which may indicate that the students consider

that TCM is a "hands-on" modality.

The financial choices made by students in regard to their educational fees can

be seen in Figure 5.2.6. This clearly shows that participants, when deciding

how to pay their HECS debt, students overwhelmingly decided to defer their

payment until after they have completed their training in TCM and are

working. For most students, this means that by the time they start working

they have a HECS debt in excess of $20,000. It is interesting to note that

during the time they are studying TCM 63.2% of students are receiving

Austudy, with 86.7% of students working whilst they are studying, with 13.3%

of those students holding down a full time job.

From the data, it can be seen that only 36.8% of all students had experienced

some form of TCM treatment prior to commencing their training in this

modality. However, from the Chi-Square test it was shown that the students

who undertook the acupuncture training were more likely to have experienced

a TCM treatment. This is an interesting point, what this tells us is that over a

third of students have not experienced a TCM treatment, and yet have

enrolled in a course to become a practitioner of TCM, which will cost them

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 5 2

$20,000. Future research could assess how many of these students

complete the course and how and why they decided to study TCM.

Over half of the students had studied at a tertiary level prior to commencing

their TCM course at Victoria University, as seen in Figure 5.2.10. When

considering teaching requirements this, figure is significant when

contemplating expectations from students, and their expectations of the

scholastic requirements. This data could have an impact on deciding class

sizes in areas such as tutorials and practical classes.

Of the students who had not attended a university prior to Victoria University,

it is worth noting that there was a predominance of students who attended

private colleges, which taught such modalities as Shiatsu, massage, and

naturopathy, or other areas of natural medicine. This is in line with the number

of mature age students undertaking study in TCM and may suggest that after

studying such modalities as massage and Shiatsu that there is a natural

progression to studying TCM.

When contemplating the possible paradigm shifts required to learning TCM, it

is worth noting just how many students have a member of their immediate

family who is a TCM practitioner. With 16% of participants showing those

grandparents, parents and siblings were predominantly the practitioners in the

family. Traditionally, this would have been the traditional way for a student to

learn TCM in China with the apprenticeship programme, with the student

sitting in with an older family member to learn the trade. This may take many

years and often the student only became of age when the "teacher" was to

stop working or even die. With the advent of Australian University's teaching

these modalities and the political and social pressures placed upon the


profession, the traditional ways of learning TCM will go completely in time. It is

therefore important when creating a curriculum to teach this ancient art, that

the more subtle ways of learning, which would have been experienced in the

"family" apprenticeship process, are not lost altogether. Students nearing the

completion of their course mentoring newer students can achieve this more

subtle way of learning.

Of particular interest to this study was how the students found out about TCM

training at Victoria University? This is of particular relevance when deciding

how to promote any course for acceptance and recognition within the

community. This research has raised a number of factors, which influence the

final decision. Questions thirty-seven to forty-five in the questionnaire

covered the concepts of selection interviews and information nights after

being accepted into the course. When students were asked if the length of

time the course had been established was important for them in their choice

of institution, approximately 50% disagreed, indicating that perhaps other

factors are more important in choosing institutions. This research suggests

that that the students own personal perception of the institution is of more

importance, the actual contact they have with the institution prior to starting

the course, or perhaps the quality of information, or response from staff that

make students feel more comfortable. This question is bourn out with the

results of the questions on selection interviews and information nights, with an

overall response rate of 70% in the "mostly agree and "Agree" section. What

does this response say to those involved in the selection and process of

offering places to prospective TCM students? Do students feel that after they

arrive in the course, that a selection interview would offer a different selection


of fellow students to the ones they have? Do they feel that if there was an

interview that they would get something, which they feel they missed out on,

by being offered a place through the VETAC system? Or is it that a selection

interview gives credibility to the course, is it that a selection interview adds a

level of professionalism to the modality they are about to enter. Perhaps the

response to the question relating to a pre-enrolment session being offered to

the student after they had been selected but before they actually started the

course is more significant. Is it that student's feel that they arrive on the first

day of the course very unprepared, not knowing anything about the structure

of the course, academic expectations, etc? This view of students is

something, which the staff within the School of Health Sciences, at Victoria

University may need to reassess, to see what can be offered to students prior

to the commencement of their training. Perhaps the exploration of exactly

what students think that they should or would get from a session may be an

appropriate way to proceed with this result.

This research has found that it is important for students to know which days

they are required on campus prior to the commencement of their training, it

has already been demonstrated by these survey participants, in Figures 5.2.8.

and 5.2.9. that a high number of students work whilst they are at university.

Figure 5.2.18. illustrates that 65.8% of students "mostly agree" or "agree" with

this statement, perhaps suggesting that they have to arrange their work

commitments around their class times. It would seem appropriate that the

earlier students can be informed of the days they are required on campus, the

easier it would be for them to organise their other commitments


A further area of interest is the perception of students regarding the location

and facilities available to students who study TCM. The campus is located at

St Albans, Melbourne's western suburbs, and traditionally a working class

area of Melbourne. Participants were asked about the location and facilities

available to them, the response was, that whilst they felt that the facilities

were adequate for TCM training, with 66.2% responding with "sometimes" to

"Agree", the actual location of the campus was of little importance to them

when they were looking at the various courses available in TCM. It is perhaps

worthy of note here that the School of Health Sciences has in recent years

spent a considerable amount of money in the TCM area upgrading the

teaching facilities. There have been purpose built laboratories for TCM

students and the Health Practice Unit had now taken over the entire building it

is located in at St Albans and new treatment rooms for both acupuncture and

herbal students installed. A new herbal dispensary has been created with new

cooking facilities and the actual teaching facilities updated. Students now

have access to tearoom and computer facilities when working in the Health

Practice Unit (HPU).

Within this course western medical sciences and TCM theory are being

taught simultaneously. This has been a contentious issue for many years

within academia in TCM with conflicting opinions among staff. There are two

universities that offer courses in TCM in Victoria, Victoria University and

R.M.l.T. As mentioned in the introduction the course at Victoria University was

the first of its kind in Australia offering TCM at a tertiary level. However, this

was quickly followed by a course at R.M.l.T. At first it was a postgraduate

course only available to those who already had a degree in an area of


Bioscience. Then students undertook the undergraduate degree. However,

the main difference between the two courses being offered in TCM training is

that R.iVl.l.T. offers an undergraduate degree in health sciences, and then the

students in the last two years of the course are asked to learn TCM. Whilst

their course is predominantly a herbal course, there is a small proportion of

acupuncture included. At the time of the research Victoria University students

were offered a course in either acupuncture or Chinese herbs. This was

changed in 2001 when the first combined course was offered. Students are

taught the discipline in which they are studying in TCM, either acupuncture or

Chinese herbs, the western medical sciences are taught simultaneously for

the first three years of the course. The results indicated in Figure 5.2.22. show

that there is 76.4% of the participants agree with the question of whether they

valued being taught Bioscience and TCM simultaneously or not. This topic will

be further explored when discussing the responses to question seventy-one,

which is, why students chose Victoria University to study TCM.

6.2. Teaching and learning responses.

A particular focus of this research was on the student's perceptions and

preferences in relation to the quality of teaching at Victoria University. This

was covered in question forty-six and in the first instance relates to the

experience the lecturer has as a TCM practitioner and as shown in Figure

5.2.23. As expected students were found to prefer a lecturer with this

experience and as a result 94.7% stated that it was "highly important" that

their lecturers were experienced practitioners. This is highly important data

and perhaps should be looked at by the School of Health Sciences when

making appointments for staff in the future. In the classroom setting perhaps

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Hea l th S c i e n c e - 2 0 0 2 5 7

what this can be interpreted as meaning is it that students value that "hands

on" experience as it gives teaching a more alive feel, that lecturers are able to

draw on current cases for examples in subjects being taught. Future research

could explore the possibility that there is amongst students a perception that

there are practitioners out in the community that can achieve what the

students are endeavouring to do. Perhaps it is confirmation that they have

chosen the right career or that they value the "wisdom" that comes from

practice. Conversely, maybe they view lecturers that are not experienced

practitioners as not knowing as much, or as having limited experience and

therefore knowledge of the subjects they teach.

When looking at the statement that lecturers are currently in clinical practice, it

can be shown in Figure 5.2.24. that an overwhelming majority of students

81.6%, felt that it was "highly important" that this was the case. When looking

at both experience as a TCM practitioner and currently being involved in

clinical practice in relation to the expectations of students, the results are as

expected that clinical practice is highly valued within TCM students. The

ramifications of this result are that, is it not always possible to work as a

practitioner and teach TCM. Is it perhaps something, which the School of

Health Sciences will have to look at when next appointing new TCM staff

members, ensuring that they are currently in practice. Perhaps full time

appointments will not be feasible in future if this quality is to be maintained

within teaching staff. A further argument could possible be that is it feasible for

full time staff to be expected to maintain a practice as well, working evenings

and or weekends in a clinical setting to maintain this current contact with

practice. How does Victoria University view this aspect of teaching quality,

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 5 g

how does it apply in other modalities and faculties within the university? It may

be of interest to look at this aspect when deciding which lecturers teach which

subjects or areas of TCM. Should the more practical "hands on" lecturers who

maintain current contact with patients teach specific aspects of the course.

What was also significant was that there was no difference between herbal

participants and acupuncture participants. This result shows that both groups

respect the clinical practice of both modalities.

A further dimension relating to clinical experience studied in this research was

that of the clinical teachers, they are teachers who supervise students during

their training. Participants were asked whether clinical teachers should be in

private practice and whether or not they should be academics. Clinical

teachers work with the TCM students in the various clinical locations

available, in a variety of setting and where students have the opportunity to

treat patients with health problems. As shown in Figure 5.2.25. over 92% of

the participants viewed the statement that clinical teachers should indeed be

in private practice, it could be seen by this that current clinical knowledge and

experience are valued highly by students. Perhaps the student has

confidence in the clinical teachers who will be able to assist them in coming to

a TCM diagnosis or treatment regime. With the possible belief that the clinical

teacher has perhaps treated this condition before, that they have experience

to call upon and knows what will happen when a certain treatment is used,

either in acupuncture or Chinese herbs. For students the uncertainty of what

they are doing and the lack of confidence in themselves when first treating

members of the general public can be quite immense. When considering if

clinical teachers should be academics or not, the response from the

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 5 9

participants was as shown in Figure 5.2.26. tliat 72% felt that it was

"important" to "highly important" that clinical teacher were in fact not

academics. In discussing this aspect of the teaching and learning questions,

what must be looked at is the perception that TCM students have about

academics. Maybe they feel that they are not current in clinical knowledge,

that students might not feel quite so confident about having an academic with

them the first time they treat a patient. Other possibilities are that perhaps the

academic might not have recently seen the particular syndrome or illness the

student is treating.

From the four aspects covered so far in the teaching and learning discussion,

it can clearly be seen that TCM students value clinical practice highly, that

they feel that they are getting something from having their lecturers or clinical

teacher current and up to date with practice. This trend is in line with the

programme at UTS were Ryan stated that clinical practice was listed as the

most helpful educational method. (Ryan, 1995 p 127)

Another importance aspect of being an academic is one of research and one,

which Victoria University encourages its staff to participate in. Whilst this is

possibly an academic reality, it is not always a possibility, and how important

do students view this role of their lectures. The survey participants were

asked to respond to questions relating to academics involvement currently or

in the past in TCM research. Victoria University encourages all academics to

be involved in research. However whilst this may well be true, students

perhaps have a different view as shown in Figure 5.2.27. This shows no great

significance in the graph. It should be noted that the sample was spread

consistently over the graph with only 28.9% giving this question some

Vivienne J. Wil l iams. 3047674, Master of Health Science-2002 5 Q

importance, and stating that they thought it was "important" that lecturers were

recently published in the area of TCM. This was clearly a question, which did

not stimulate any great response of consequence. When participants were

asked about lecturers being currently involved In research, the response was

that 52.6% viewed it as "not important" or " some importance". Burnaford

(1996 p 125) states that, we view all this as a life of inquiry-vital and essential

for teacher growth and professional development. Whilst this may in fact be

true, it may be that some students view research with some ignorance or fear

as to actually what is involved or what research means. With little or no

funding available for research into clinical trails in TCM, students are not

exposed to the possibilities of what research will achieve. This in itself may

have an impact on the beliefs that students have around research. Research

is also a subject, which is taught to students in the TCM programme, the

delivery of such a subjects can colour a student's view on ideas about

research per se.

Of particular Interest is the result of questions asked in relation to lecturers

being trained as teachers and lectures being interactive? As can be seen in

Figure 5.2.29. which relates to lecturers being trained as teachers, a 92.1%

stated that was "important" to "highly important". It can perhaps be assumed

that the students are saying that they believed that teachers are better

equipped to transmit information across to students. However, as the

participants are not aware of the qualification of staff members, perhaps there

is an assumption that staff are trained as teachers. Teaching is a skill; not

everyone is born with it, should higher education be responsible in training

basic teaching skills to its lecturers. Becoming better informed about

V i v i e n n e J. Wi l l i ams . 3047674 . Mas te r of Heal th Sc ience -2002 5 j

education, will not assure better performance as an educator. The translation

of knowledge into doing requires a different kind of assistance: direct

observation, analysis, and critique of teaching itself. (WHO, 1973 p 15).

Should lecturers whose path will take them into teaching in higher education

undertake to participate in a basic teaching course prior to commencement of

their position in higher education? Even the statement made in 1973 by the

WHO, (p 14), that the assumption that qualification in subject matter is

equivalent to qualification for teaching has been accepted for so long in higher

education that an educational research and development centre can

anticipate some measure of resistance to this aspect of its work. Continuing

this trend of scrutinising lecturers teaching skills, Warren-Pipe (1994 p 227),

states that there is no requirement for people appointed to academic posts to

have any formal education in the process of teaching and examination.

Perhaps this could be a future research project to establish perceptions with

both lecturers and students on this topic.

Teaching is by definition the ability to pass on information to others. As

undergraduate students there is an expectation that at this level of education

a certain amount of self directed learning would take place. Is TCM a difficult

subject to learn, which requires more "information" sessions than for other

courses? With 63% of students between the ages of 20 and 30 years is there

an expectation that they can find out information for themselves. There

appears to be a trend in universities to adopt the styles of "self directed' and

"problem based" learning, and the School of Health Sciences is following this

trend. Self directed learning is a process of learning whereby students are

given either "work books" or learning concepts to explore for themselves

V i v i e n n e J. Wi l l i ams . 3 0 4 7 6 7 4 . Mas te r of Hea l th Sc ience -2002 5 2

outside of the normal classroom teaching time. One definition of problems

based learning (PBL) given by Finucane et al (1998) is an educational method

characterised by the use of patient problems as a context for students to learn

problem-solving skills and acquire knowledge about the basic and clinical

sciences, again outside of classroom teaching time. However, Evensen et al

(2000 p23) adds that the problem is supposed to trigger the students learning

process, and problems should be adapted to the knowledge level of the

students. Something, which must be assessed frequently that this is in fact

happening by definition a technique well, adapted to learning TCM. Staff are

expected and supposed to be available to assist students when necessary,

and to give them guidance and direction to assist in the completion of the

task. Classrooms and times are also allotted to self-directed learning on the

timetables. The TCM programme, which commenced in March of 2001, is

such a programme, it incorporates approximately one fifth of the entire course

under the heading of "self directed" learning. This was constructed in this way

to cut teaching costs and therefore to make the course more "viable"

economically. As it is still in its first year of teaching it is not appropriate to

make a statement as to the effectiveness of this method neither of teaching

nor of the response from students being placed in this course. However, if the

trend is followed from Ryan's research in 1995 at UTS, were students

responded negatively to increases in "self directed" learning, this issue may

have to be revisited.

In relation to the actual lectures, 89.5% felt it was either "mostly important" or

highly important", that lectures should be interactive as shown in Figure

5 2 30. This would perhaps indicate that students do not want to a


pedagogical approach to their lectures. Conceivably, students feel that there

needs to be an aliveness to lectures, and that interaction happens between

lecturer and students and between student and student. Perhaps students

find learning more enjoyable when lectures are Interactive. So when looking at

the questions addressed in Figures 5.2.29 and 5.2.30. it can be seen that the

participants really place great emphasis on what actually happens in a

classroom. It can only be surmised that class interactions, whether it be the

use of such teaching aids as videos, slides, PowerPoint presentations, small

group work or humour, as widely used in medical teaching (Ziegler. 1999 p.3)

as the reasons for this response. Students may well be happy with the status

quo at this stage and no change is necessary.

Participants were asked of their perception about the number of hours taught

in the classroom and if they felt that they were adequate. It is worth noting that

from Figure 5.2.33. that there was an impressive separation of responses.

With 21.1% "disagreeing" and 10.5% "agreeing" and 57.5% placing their

response in the "sometimes" and "mostly agree". This area of teaching is

always controversial, how many hours are assigned to each subjects, how

many of these hours should be in lecture or tutorial form. How many hours

should be assigned to clinical work within the course and how many hours

should be in outside locations? Maybe that with a response rate of 21.1% of

participants disagreeing that the hours taught in the classroom were

adequate, several variables should be then be investigated. It is not possible

to see from the results whether these students are school leavers or mature

age student and whether they have studied at this level. However, there is a

minor correlation between those students who believed that teachers should


be trained, as teachers and that they thought the number of hours taught in

the classroom were adequate. Whilst it is not possible from this correlation to

know why this is perceived by students, it could be postulated that perhaps

students feet that the way in which material is delivered within the time

framework is significant.

Whilst looking at teaching, additional criteria such as current TCM literature

and computer based programmes were assessed. Lecturers being up to date

with current literature was thought to be "highly important" by 78% of the

participants. However, there was no significant correlation between

participants feeling that lecturers should be involved in research and that they

are up to date with current TCM literature. This perhaps indicates that whilst

the participants expected their lecturers to be current with their knowledge of

TCM, there was no expectation that their lecturers should be currently

involved in research.

One area of change within the teaching arena is that of computer based

programmes and this is so within TCM teaching. These programmes show

clearly acupuncture points on a body, or give details of specific herbs, which

should be used for particular conditions. There are some basic examples

available on the Internet; however, the School of Health Sciences has

purchased a highly sophisticated and evolving programme for the TCM

course. This programme is called "Focused Knowledge Systems" and was

designed by Paul Turner a graduate from the TCM course. However, at

present mainly the Chinese herbal students use the programme. From a

correlation with the herbal students which showed that whilst they are

currently using computer based programmes as part of their daily teaching


activities they have no expectations that the lecturers should be up to date

with them. However, for the acupuncture students the correlations showed

that although they do not use computer based programmes as part of their

daily teaching activities, they did have an expectation that lecturers should be

up to date. However, who does expect lecturers to be up to date with the

computer programmes.

The final grouping in question forty-six relates to the perception the

participants have of their lecturers as people. When asked to comment on the

statement that lecturers are seen to "practice what they preach", 78.9% rated

the statement in the "most important " and "highly important" categories as

shown in Figure 5.2.31. Traditional Chinese medicine is a total paradigm shift

from the western culture that most participants have been exposed to. Some

students on commencing the course, have great difficulties with these shifts

and as such often cannot cope with the course and leave it prior to

completion. Some of the paradigm shifts are outlined in the introduction.

Students learn about the importance of eating the correct foods for certain

conditions. An example of confusion for the student would be if they saw a

lecturer in the campus cafe eating buckets of chips or greasy foods, and they

have just been taught that this might contribute to certain illness or

imbalances. This blatant disregard for the principles of TCM may have a

dramatic effect on a new student.

Whilst it is acknowledged that lecturers are individuals and as such have a

right to choose how they live their life, it is obvious from this survey that

students find it very important. Perhaps young students require role models to


re-enforce the paradigm shift that is necessary for students to feel safe in their

choice of career.

The role of the lecturer in a health discipline is fraught with difficulties. Should

they be themselves, eat, drink, smoke and live how they please, or should

one expect their role to be that of example as well. How confident would one

feel if we went to a weight loss centre and all the advisers were over weight?

When learning a new discipline, the aspect of a living example is one, which

should not be dismissed.

In continuing this theme, students were asked about their thoughts on the

statement that lecturers are professional in their role. The research clearly

showed that 94.8% of participants felt that this was important. Professionalism

can mean many things to many people. If one were to look literally at the

Macquarie dictionary (1995 p 317) it states that professional is something that

someone does or produces that is of a very high standard as a means of

livelihood or gain. However, Kultgen (1988 p 4,) states that the term can be

taken narrowly to refer to the traditional "learned" professions and Larson

(1977 p 2) states that professionals are relatively recent social products. He

also goes on to state that ethics and professionalism are very much

intertwined with each other arguing that professionalism should be conceived

in such a way that it is limited to moral conduct and elicits moral conduct, and

that morality should be conceived in such a way as to require professionalism.

Larson (1977 p3) suggests that the post revolutionary societies became fertile

ground for the professional development and multiplication. Larson (1977 p 4)

goes on to state that as for medicine, given the universal need for healing and

the ineffectiveness of most therapies, it was more sharply and divided by the


social position of the practitioner's clients than by the origin of the techniques

that were applied. This is certainly an interesting concept when applied to a

technique with such a history and from an eastern culture, not from our own

culture. For the purposes of this research there is no way to define exactly

what students call professional, however, it is probably fair to assume that

their interpretation of the word is similar to that of both Larson (1977) and

Kultgen (1988). Perhaps it can be assumed that students require certain

ethical and moral standards from lecturers and this would of course require

further research and investigation to answer this question.

Students were asked to respond to lecturers being politically active within their

profession. As can be seen from the introduction many attempts over the

years to regulate Traditional Chinese medicine became fruitless. However in

2000 this changed. A number of TCM staff at Victoria University were involved

over the years in getting TCM where it is today and with the formation of the

first TCM registration board in December 2000, also came the announcement

that two TCM lectures from Victoria University were on this board. It is

interesting to note that 52.6% of participant's thought that it was "not

important" or of "some importance" as shown in Figure 5.2.32. Has this result

come about as a result of ignorance of what is happening within the TCM

profession in Victoria, or is it that the participants are still students and as

such do not foresee the ramifications of life as practitioners and working in an

unregulated profession with its legislative restrictions on practice.

6.3. Direct effects on students studying TCIVI

Students were asked if they looked forward to their TCM lectures, 55.2% of

the participants stated that they "mostly agreed" or "agreed" to this statement.


This aspect in student's enthusiasm will be further explored when discussing

their passion for TCM and the relationship between the two aspects.

Students and possibly academics, often have the perception that academic

staff should be in their offices whenever their doors are knocked on. When the

students were asked about availability of course coordinators and lecturers

the results were not as expected. Around one third of students thought that

their lecturers should be available and less than one fifth thought that the

course coordinator should be around when needed.

When reviewing the results to questions about students stress levels and

learning both TCM and Bioscience the response was as expected with

learning TCM. Students did not find learning TCM stressful however, the

results about Bioscience showed that the participants did find learning this

area of the course stressful. This is in line with Ryan's (1995 p137) finding at

UTS, where students viewed the complexity and quantity of Bioscience

information required more time than studying TCM. This issue is one, which

has been discussed between faculties at Victoria University, and there have

been structural changes to the Bioscience course content. Whilst this

research did not ask for specific details as to why Bioscience is stressful, it

can be perhaps assumed that, as it is not an area that students primarily want

to learn, that their enthusiasm is not placed in that direction. There is perhaps

a perception amongst students that if they are going to learn TCM, then that is

all that they do actually learn and when faced with subjects such as

Bioscience or even psychology or counselling their interest diminishes

noticeably.

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Heal th S c i e n c e - 2 0 0 2 5 9

When reviewing what students feel about how and what they are taught,

questions fifty-three, fifty-five and fifty-six are specific to how TCM knowledge

both theoretically and practically as well as clinical exposure is perceived. The

result was both unexpected and engaging in that over half of the respondents

felt that TCM theory was taught to them in a way that was easy to understand.

Whilst the response to the practical classes question found that the majority of

students placed their response in the middle of the Likert scale, covering

"sometimes" and "mostly agree". This perhaps shows a trend towards

dissatisfaction with practical classes, but as details were not asked for, further

suppositions cannot be made. It is however; worthy of note that Ryan (1995

p143) found UTS students feeling that practical application of theory should

not only be present in each semester but each class. This concept is one

which to date has not been introduced at Victoria University, however, it may

be an option which staff could possibly look at in order to raise the profile and

satisfaction with the practical classes.

All students enrolled in both the Acupuncture and Chinese herbs course are

required to undertake 649 hours of clinical experience. This experience starts

from the second semester of first year and continues throughout the course.

In the first three years students have opportunities to be assistant

practitioners and in the final year the fourth year students become student

practitioners. As assistants students work with the student practitioner and a

clinical teacher in many locations both on campus and at various locations

around Melbourne. Many of these clinics are Drug and Alcohol withdrawal

units, and this is because TCM works so well for withdrawal as argued by

Shwartz et al (1999) other locations range from a women's prison to the


Salvation Army, treating all types of disease. Fourth year students also have

the opportunity to finish their clinical internship in a hospital in China, where

they work in the outpatients and in the in-patient departments. It must be

noted that from the survey it is impossible to know which respondents are in

which year, hence their experience so far in clinical exposure may be limited.

This may impact on the results, which showed that almost 60% of participants

felt that they had sufficient clinical exposure at their stage of the course.

However, when students were asked if their clinical placements allowed them

to treat a good cross section of the population almost one third felt

dissatisfied. This figure is not significant overall. However, maybe for future

reference, new clinical placements should be sort in locations, which do in fact

offer a broader cross section of the community, for students to treat.

Continuing with the theme of clinical experiences, students were asked if the

clinical teachers were willing to share their clinical experiences with them. The

response was complimentary with 63.1% of students "mostly agreeing" or

"agreeing" with this statement. As was shown with the question asking

students if their clinical teachers should be in private practise and with a 92%

response rate in the affirmative, the importance which students place on their

clinical training is evident, and as such the information gained by being with

clinical teachers who are currently in practice is met with a positive response.

Perhaps an area of training in TCM, which is not always one, thought by all

students to be of great importance, is that of the philosophical and spiritual

aspects of Chinese medicine. As mentioned in the introduction the paradigm

shifts often required by students who have had no previous exposure to

Taoism, Confucianism or even basic TCM concepts can be challenging. The

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 7 J

spiritual beliefs of students may well be disrupted. As has been shown in

Figure 5.2.4. students have widespread religious beliefs or non-beliefs, 44.7%

of students stated that they had no religion, with the next largest group being

Catholic at 15.8%. However, when participants were asked if their spiritual

and philosophical ideals where challenged by the course over 60% stated that

they were indeed challenged. It is not possible to know which students and

what categories they fitted into in Figure 5.2.4. but it could be possible that

some of the students who have had "traditional" religious upbringings are

being asked to make a paradigm shift when learning TCM philosophy. It is not

unusual to find that students have little or no understanding of TCM

philosophy when commencing the course. Ryan (1995 p 173) found a similar

trend with students at UTS studying TCM.

Of particular interest in surveying TCM students was the influence of passion

in studying their chosen course. Passion is a word often difficult to actually

place a meaning on, however, to find the literal meaning as is described by

Macquarie (1995 p 290), which states it as being a very strong feeling about

something or a strong belief in something. However, Solomon (1999 p 17),

brings in a different dimension when he talks about the fat, messy richness of

human life and passion is reduced to its single most celebrated attribute, so

called rationality the featureless subject-"Man is a rational animal". This

concepts takes away some of the fire in the belly, enthusiasm and zest often

associated with the concepts of being passionate about a subject. Perhaps

what Solomon is really stating here is that even when we believe we have

passion for something, rationality can hide our burning desires.


Within a western society it is often difficult to shift paradigms, and certainly

studying TCM will require a shift at some level to be able to absorb the

subjects. Many students have already spent sometime prior to coming to

Victoria University being involved in someway with TCM, it may be as a

practitioner of TCM, a student of martial arts or a student with a keen interest

in the philosophy and history of TCM. Students were asked if their passion for

TCM had influenced their choice of course and the results were unexpected in

as much as almost 70% stated that it did. Students were also asked if their

passion for TCM had changed since they had started studying TCM and the

response was that 57.9% felt that it had changed. These indicators must be

looked at in perspective with the answer from question sixty-two, where

students were asked to rate their passion for TCM on a sliding scale from

obsessive to non-existent. The results were somewhat overwhelmingly high

with 89.9% saying that they were "obsessive" to "average" about their passion

for TCM. When looking at the three responses and putting them into

perceptive, it can clearly be seen that students contemplating a course in

TCM already have a strong passion for the subject. It is also evident that

whilst students are studying TCM their passion does change. This could

perhaps be because of the workload, length of time of course, outside

commitments etc, which have an influence on their passion. However, it is

worthy of note that there are still a considerable number of students who have

a high passion for TCM. With these results for passion for studying TCM it is

appropriate to look at question sixty-one, which asks students if they always

feel, motivated to study TCM. It was therefore not surprising to find that

almost 85% of students where in affirmative to this question.


6.4. Qualitative Questions.

Whilst most of this survey was conducted with quantitative methods, and

analysed through SPSS computer programme using Likert, Mann Whitney

and Spearman correlations, as outlined on page 16, there were two questions

where students were asked to qualify their responses.

6.5. Describe Your Passion for TCM.

The first question asked students to describe their passion. The responses

can be divided into groups.

The first grouping of comments is from students who knew very little about

TCM prior to commencing the course.

"I have to admit that I went into TCM study I only (<new of vague concepts, but

I was excited at the prospect of learning."

"Considering since I started the course 2 years ago, without an idea about

Chinese medicine, my passion is huge. At the beginning I didn't even know

what "Yin-Yang" was. I thought that the symbol for Yin-Yang was a surf

symbol for the clothing company "Ocean and Earth". And that the Yin Yang's

were the mountains on the way from Melbourne to GeelongH

"It had been growing since I started studying, since when I began I didn't

have any knowledge of what TCM was. I am still interested and motivated to

keep learning about TCM and I hope to be practicing for many years to come.

I enjoy the philosophy of TCM and now apply it to my lifestyle because it holds

such meaning to me."

From these comments we can see that some students will embark on a

course in a modality, which they know very little about and are prepared to

have a HECS debt of over $20,000 at the end. Perhaps it could be said that

Viv ienne J . Wi l l iams. 3047674. Master of Health Science-2002 7 4

these students are taking a great chance on something, which they know very

little about, but also hope will give them a profession.

Then there are the students who started the course with a huge passion for

TCM.

"I gave up a secure engineering position, my cat and my partner to move to

Melbourne to continue studying, does this say it all!"

" I am very passionate about TCM. It is a part of who I am now and is just a

natural part of my life. I am equally passionate about other things too but TCM

will be with me for life."

"I absolutely love TCM and see myself studying it for many years to come."

"At first I was really passionate about TCM, and how the theory all worked

out. The passion is still there and is burning strong, however, the more I learn

the more I realise how little I know and how much there is to learn, it leaves

me feeling quite humble"

"Strong I want to learn more, see more to build up to a level where I can be

the best I can be with continually developing and gaining knowledge."

From these comments it can be seen that passion has a huge driving force,

and with that driving force some students will make life-changing decisions to

study TCM. Perhaps this is not always recommended but if it fulfils an

ambition and a drive, which can be maintained over four years, then it should

not be questioned.

Students who have lost some of their passion since starting the course

" Initially my passion was strong but after the completion it is not as strong.

My passion is still there and hopefully I shall use my education, but I have

changed my enthusiasm

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 -75

"I was very passionate for TCM before I began this course, l-iowever, it soon

became more of a burden due to the overwhelming worl<load."

"It comes and goes. I find the immensity and complexity of it overwhelming.

It's easy to have a passion for something that you just dream of or idealize.

Having gone deeper than that I realise how far you can go with it. TCM

learning should not stop-cannot stop. There is scientific research to be done

and integration with western medicine and western people and society."

"My passion-or rather the excitement and interest in learning comes mostly

from clinical practice and discussion with peers. I am not obsessed by it

because there are so many other things in life I wish to spend time and

energy on. But I still want to work in this field, I still want to be a good

practitioner and I want to keep learning more. Just slowly."

" I don't know, it's not as fun as I thought it would be or as interesting. I still

want to complete this course no matter what."

"Bit burnt out at the moment due to pressure related to external work

commitments. Therefore are currently considering deferring for one year to

see if my motivation/passion for TCM increases to the level it was when I

started the course."

" My passion for TCM has declined over the years. This is because I am not a

good academic. I only enjoy studying for short periods of time. My plan is to

go back to work and go on a long holiday and then return to VUT to return to

TCM. I think I want to be a TCM practitioner but I will decide when I get back

from my holidays."

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 -yg

From these comments it is obvious for tlnese students that the workload has a

huge impact on their passion for TCIVl. Terms like "burnt out" and "burdens of

overwhelming workloads" give an indication why their passion has changed.

Students whose passion has changed

"It is getting stronger as the course goes on with the more

knowledge/practical sessions gained."

" In the last year my passion for TCM has increased immensely. Experiencing

different aspects of TCM and confirming my uncertainties of TCM. Practical

experience this year has increased my interest in TCM and given me an

opportunity to enjoy what I do. I now have a further interest in the philosophy

behind TCM and plan to do reading, learning and experiencing more for

myself in order to become a successful practitioner."

" I feel that my passion is strongest when I am stimulated with more practical

application. I am passionate about TCM to the depth of my spirits and wish

that there was more "energetic work" in the course and more practical clinical

work that allows me to see more than just withdrawal patients-more like the

HPU. My passion will grow no doubt when I am in clinic learning more by

experience and seeing more results when cases-real cases, drive me to

research."

"I am very passionate about TCM. I feel that I have been given grounding in

TCM at VUT Now I will explore within my own areas of passion relative to

TCM"

"Its something that keeps developing as I learn. I have a huge passion for

alternatives to western healing and though whether I am TCM alone I am not

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 y-y

sure. I was not planning to study herbs yet as I wanted to do acupuncture, so my passion for herbs is now developing.

" I am passionate about TCM, less so about academia. I wouldn't like to see the course valuing academic excellence-eg. the ability to write a good essay higher than the aptitude of students for applying TCM knowledge and ability". These students seem to state that their passion has increased during the

course of their training for different reasons. With several mentions of clinical

experiences and therefore the ability to treat patients, this seems to have re-

inforced the knowledge the student has gained over the time they have been

studying and appears to be sufficient to stoke the fires of passion. It is also

interesting to note that students, who from their comments must be nearing

the completion of their course, are looking forward to being able to do such

things as research, and explore and create their own passion from within as

they practice. Again the theme of academia putting a dampener on students

passion is raised by statements such, as they are passionate about TCM but

not academia.

Finally there are students who have different reasons why their passion has

changed.

"Initially, professionally driven-set out to gain further qualifications for my future benefit-once I'd decided to do this, committed myself to doing well. Now-very satisfied to have finished this course, now ready to explore my own relationship to TCM-find out where my affinities are and see what passions emerge through the doing". " I believe that with a strong passion for TCM we can have a strong focus

when treating using the TCM paradigms. Some times too much passion for

Vivienne J. Williams. 3047674. Master of Health Science-2002 y g

TCM Cdn blind ones judgments when allowing for other infornidtion and

frameworks into our work".

"When I view TCM from the viewpoint that it encompasses all natural

therapies then my passion is higher than when I view it as a separate modality

that is fixed in traditions based in the dim dark ages."

"Passion is a very difficult word to use to describe my commitment to TCM. I

am no more passionate about TCM than any other modality, such as

counselling, or biomedicine etc. There are certain areas that TCM particularly

excels in and other areas that TCM has less to offer."

"I love TCM. The thought of helping people motivates me. Knowing that I can

help people without western medicine is important to me."

" I find TCM a wonderful thing to study. I like to help people resolve illness. If I

am doing this I am happy and my passion for TCM is high".

"Since starting to study TCM-the scope of things to learn has broadened and I

have no limitations-can see no boundary-where I will finish learning-endlessly

amased by the complex patterns and yet the simplicity of it all. Skipping with

joy-even when stressed, able to smile and breathe through it."

"I see TCM as a lifestyle and I'm passionate about living my life in

accordance with TCM ie, diet, seasonal etc. I am passionate about being able

to practice in my own clinic however, I feel that I still have a lot to learn."

"I have great respect for TCM, always have and always will. I admit that some

lecturers have put me off TCM at times but there were others who would give

me inspiration."

From these comments, perhaps the overall message which comes through it

that whilst they are not necessarily openly passionate about TCM, it is still

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 - 7 9

there, disguised in words such as, lifestyles, commitment and focus. As these

statements are taken from the survey, it must also be noted that not all

students chose to describe their passion. Maybe this can be interpreted, as

not being in touch with their passion in the literal sense, perhaps for them it is

a feeling, a knowing or something else for them.

6.6. Practice Ideals

A very important aspect of any university course is what will students do with

their qualification at the end of their training. It is to this end that questions

were asked of students about their intentions. Unexpected findings were

shown in response, over 60% of students reported that they would "definitely"

be setting up in practice. There were an additional 21.1% who stated that they

would probably be setting up practice. This means that approximately 80% of

students intend to practice in Chinese medicine, be it acupuncture or herbs.

The next question asked to them was where they going to work in a multi

modality practice, the response rate were that 39.5% said "yes" and 44.7%

were still "unsure". When comparing these figures with those of the question

regarding establishing their own clinic the response was 52.6% that they

would be going in this direction. These figures are quite astounding when one

considers the cost of establishing a private practice. A practitioner would need

to consider equipment, advertising, legal fees, rental or purchase of premises

and on going costs, not a cheap option, especially if the students have a

HECS debt of around $20,000 as well. Students were asked if they did

establish their own practise would they have other practitioners working there

as well. It was quite unexpected that 44% of participants said that they would

indeed have other practitioners there. However, what was probably more

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 g Q

unexpected was that a staggering 73.7% said that they would prefer to work

with another TCIVI practitioner. One can only surmise that there is a "safety in

numbers" psychology attached to this response rate. Perhaps practitioners

who are new in practise feel that they need to have someone of their own

modality working with them so that they can "bounce" ideas, diagnoses, and

treatment protocols off the other practitioner. Maybe new graduate feel so

insecure about what they are doing that they feel it is important to have

someone there who knows the modality to give them confidence. Perhaps

they view this other TCM practitioner in a similar vein to a clinical teacher at

Victoria University, where the patient's case history can be discussed and

confirmation given to the practitioner that they are correctly treating the

patient. The research did not give details such as, were the acupuncture

students saying that the other TCM practitioner that they would like to work

with was an herbalist or vice versa. This would of course complement a

practise to have both modalities working together. There would perhaps not

be such an issue of loosing patient's to the other practitioner if one practitioner

couldn't do what the other did.

Students were also asked if they would work with a range of other modalities,

including G.Ps, chiropractors, osteopaths, naturopaths, psychologist and

counsellors, a dentist or a massage therapist. When looking at the responses

between the chiropractors and osteopaths, which work in a similar way, with

public perception that they both work on the spine, students responded that

42% were unsure about chiropractors and 50% were unsure about

osteopaths. Perhaps the difference in the response rates indicates that the

public has a better understanding or acceptance of the work of a chiropractor

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 g j

than maybe an osteopath. Only 55% of participants said that they would like

to work with a naturopath. Presumably TCM students are also unsure as to

what a naturopath actually does in their own practise and it is also interesting

to note that statistically the participants felt the same way about working with

a psychologist or counsellor. There was nothing exceptional about the results

of students working with general practitioners with 36% saying 'yes' and 39%

'unsure'. Perhaps what participants are saying is that they feel that GP's

would not afford them the respect that they believe they should get, that GP's

also use TCM, acupuncture in particular, and therefore they would be seen as

competition. The modality, which gives perhaps the most surprising response,

is that of working with a dentist, with a resounding 42.1% saying 'no' and only

10.5% saying 'yes'. In recent years a number of graduates have found

themselves working in dental practices. The reason for such a phenomena

cannot be easily explained, but supposition can be made that as acupuncture,

in particular, can help with pain relief, it maybe that dentists are in fact very

open to acupuncturists working with them. The final modality is massage and

there was a response rate of 55% saying "yes" that participants would like to

work with a massage therapist. Maybe this response is such because there is

a perception that both TCM practitioners and massage are "hands on"

modalities.

From these response rates it can be clearly show that the only modality,

which students feel, they would prefer to work with is one of their own kind, a

TCM practitioner. Perhaps pondering on this result for a moment, it has to be

said that very few students identified themselves as being near the end of

their course. It is not known how many participants are first or second year

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 g 2

students whose exposure to other modalities is limited. Students in the fourth

year of their course are exposed to lectures from chiropractors, osteopaths,

naturopaths, and psychologists. It may be after hearing these lectures and

then perhaps understanding more about how the modality works that students

are in fact better informed about each of these modalities. This is perhaps an

area where TCM lecturers could broaden current student's minds as to the

inclusiveness of such modalities. Students were then finally asked to specify

what other modalities they would like to work with, the responses included art

therapy, homoeopathy, hypnotherapy, medical initiatives, Reiki, Kinesiology,

physiotherapy, beauty therapy and aromatherapy all of which are as varied as

are the students.

6.7. Why did participants choose Victoria University?

The final question asked to students was, why did they choose Victoria

University to study TCM. This quantitative question gave students an

opportunity to express for themselves the factors, which made them choose

TCM at Victoria University. Once again the responses can be divided into

groups, the first one being one related to gaining a bachelor degree at a

university.

"If going to do the study, I may as well get a degree, - Not having done VCE,

could easily organise bridging course in chemistry, and biology to meet entry

standards for VUT."

" Only university offering the course as a degree at the time."

"It was really a process of elimination-cost prohibiting studying at a private

college plus they didn't offer a degree course".

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Heal th S c i e n c e - 2 0 0 2 g 3

"It's the only Chinese herbal degree in Victoria. I am planning to complete an

acupuncture degree somewhere closer to home."

"It is a 4 year degree."

"The course being in a university played an important role in my decision in

regards to accreditation- being a Bachelor degree- deferred payment of

HECS".

"I chose VUT because it was the only bachelor degree course and I wanted to

gain the highest qualification possible".

"The fact that Vic Uni is a university made a difference to me as it made me

feel more secure in the degree and its reputation".

From these statements we can clearly see that there are students who feel

that it is important to gain a bachelor degree from a university. With the

implementation of registration within TCM as outlined in the introduction,

clearly practitioners are looking at what may well be perceived as the bench

mark qualification for registration. Perhaps from these statements the

respondents demonstrate that they have explored the profession and its

development prior to enrolling in the course.

Responses from students who wanted a HECS payment option rather than an

up front full fee paying option.

"I chose to do it at the uni not private school because of the availability of

HECS and recognition by the public."

"Recommended by " "and also the HECS option."

"I felt it was the best place to study TCM. It was also covered by HECS. I am

also able to study acupuncture afterwards as well."

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Hea l th S c i e n c e - 2 0 0 2 g 4

"Because other uni's do not teach/have this course, that allowed me to pay HECS."

"It would be a recognised course for registration, plus being able to do it by HECS made it financially easier

"There was the HECS part of it as well-private colleges are too expensive and I had no means of paying up front."

" HECS covered the course as well recommended this institution on the basis of it being a uni not a college" The theme, which seems to run through these statements, is that financial

considerations are of the upmost importance in choosing courses. As outlined

in Figure 5.2.6. which showed that 77.5% of students defer their HECS

payment, this is considerable and would have a monumental impact on

studying such courses if this option were very removed. However, this figure

has implications for private institutes, which rely on up front fee. Perhaps this

could be translated as students who are financially unable to support

themselves take up HECS funded places and students who are financially

viable take the private college, up front fee option. This would certainly make

very interesting research in the future.

Students who from their responses obviously compared courses available to

them in TCM make the next groupings of statement.

"Having just completed a 3 year science degree and told that R.M.I. T. doesn't give exemptions easily for previous study. I couldn't bear studying science for another three years. Also I believe that having only two years of TCM study like R.M.l.T. has was not going to be enough and therefore I chose VUT. I was also offered a place at R.M.I. T. and declined."


"At that time R.M.I. T. required a higher level of VCE subject for entry.

"I would not have been accepted at R.M.l.T. because I didn't have a scientific

background".

"At the time it was the only choice other than UTS that enabled one to study

TCM at a university"

"Length of course and comparative greater emphasis on TCM than at

R.M.l.T."

"R.M.l.T. offered the two year TCM post graduate course-which I felt was

inadequate to learn acupuncture and herbs, also the undergraduate BHSC

course ivas mainly comprised of western science subjects, chemistry,

physics, histology, which I felt made the course western science focused."

"VUT offered 4 years of mainly TCM theory and practice-l felt that it would

give me a better understanding, philosophically, theoretically and practically of

TCM"

"Because it was offered there (Vic Uni) and sounded better than the R.M.l.T.

course. The course itself is really good and the HPU is great."

"I probably would have gone to R.M.l.T. though their entrance requirements

for mature age were too rigid. They also have too many sciences in the earlier

years and not enough TCM."

"Victoria University is where you learn about TCM and the practice of TCM

experientially. Where R.M.l.T. is where you learn Chinese medicine without

the background and context of the real spiritual and paradigmatic aspects of

TCM."

"It comes down to TCM as a lifestyle at Vic Uni but TCM as a therapy and that

R.M.I. T. TCM as a therapy that taught without context."

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 g g

7 chose Vic uni because it was offered as an undergraduate course and it

took less time than R.I\/I.I.T."

"I was deciding between VUT and R.M.l.T. mainly because I couldn't afford to

pay up front fees. R.M.l.T. was too western science based-which is an area I

was not too interested-nor confident in. I wanted t get as much TCM

knowledge as possible. Certainly I wanted TCM as the main focus throughout

the course. That was the deciding factor. VUT had more emphasis on TCM

subjects. I felt that the R.M.l.T. course was a more intellectual or academic

course. I am not that way inclined."

"I live in Melbourne and it was the only uni course available in TCM other than

R.M.l.T., which first requires you to complete a BSc. Partly because there

were no up front fees. Partly because R.M.l.T. seemed to be very western

medicine/science focused and I have no interest in this area-1 have studied it

before. Partly because it was recommended to me by someone who used to

teach there. Given the lack of fees and that R.M.l.T. was not what I wanted

the choice was rather narrow. Also partly because it was in Melbourne which

is where my supports are. I returned from interstate to do the course."

"It was my second choice to come to VUT. My first choice was R.M.l.T. where

I attended very briefly. But due to timetable clashes at R.M.l.T., I transferred

to VUT where the timetable suited me better at the time. I enjoy the

atmosphere of the group that I am in; these are a lot of fun caring and

committed amongst the students in my year. This is what keeps me coming to

VUT so far. I had attend other universities before, I don't really enjoy the

highly charged political climate at R.M.I. T."

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 g y

"TCM would be taught straight from the beginning unlike R.M.l.T. where it was

to be introduced further into the course. At the time it was the only university

that offered TCM. R.M.l.T. did offer it but it is more western medicine. I would

much prefer to learn more TCM than western medicine".

"The course has a better reputation. It was between two degree courses

covered by HECS-R.M.l.T. has too many science based subjects and 2 years

full time combined acupuncture and herbal; this does not seems enough. Am

interested in using time available to learn the most and benefit from teachers

etc not just get the accreditations -therefore the R.M.l.T. course didn't have

enough time given to the TCM subjects-merely overview. Good to be able to

study herbs separately and then continue by studying acupuncture here or at

any other place offering. (Herbs only offered here!!)".

"It was the only university that offered a TCM degree without having to do the

western medicine first like R.M.l.T."

Whilst the purpose of this research is not to make judgements in relation to

other universities or private colleges, comparisons are always made by the

consumer, the students. As previously mentioned the TCM course at Victoria

University has been established since 1992 and was the first of its kind in

Australia. R.M.l.T. started its course in TCM shortly afterwards but took a

different focus. At first the course was primarily a graduate course for those

with a medical background wanting to learn TCM. This then changed and it

became an undergraduate course but as can be seen from the comments by

students this fact in itself deters certain students from choosing R.M.l.T.

R.M.l.T. has always taught it Bioscience at the beginning of its course and

then students learn the TCM component in the final half of the course. From

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002

the statements made by students there is an obvious assumption too that the

R.M.l.T. course is harder academically. There is no way that can be

determined for the purposes of this research nor is it an aim to do so, but the

only statement that is factual is that both Victoria University and R.M.l.T. take

students in each year into their programmes, both appear to be fulfilling their

university requirements in the form of numbers of students, so the only

assumption which can be drawn from this is that there are students who

prefer to have TCM taught simultaneously with Bioscience and there are

students who like them to be taught quite separately and in no way influenced

by TCM.

Responses from students who wanted to be taught one modality of TCM at

the time.

"The clear separated programme; I mean separation between acupuncture

and herbals. TCM subjects and western subjects have been taught

simultaneously, parallel. The most advantage has been gained when theory

and clinical have been taught at the same time. They would supplement each

other."

"I wanted a comprehensive herbs only degree with no acupuncture initially.

Planning to do acupuncture later."

"More hands on TCM subjects. More hands on with raw herbs."

"Because it was the only school I knew of that offered Chinese herbal

medicine at the time when I completed my VCE".

"Because it was the only university I was aware of that offered acupuncture."

It appears from these statements that usually students know which area of

TCM they want to study. Then as a process of establishing which course will

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 g ^

give them what they want, they then decide on the institution. How

comprehensively covered is their area they choose, for example, how much

"hands on" experience do they get in the course all help to support the

students decision.

The reputation of the course at Victoria University is sighted in some of the

student's responses.

"It seemed quite new and organised and the staff seemed approachable and

friendly during the initial open day of the university."

"Vic Uni seemed to have the only and best option. It had a good TCM

reputation course".

7 was told it was a good course by a friend. I liked the fact that it was

traditional. It seemed very comprehensive."

"Good University"

"The reception I received was on a very personal level, and I felt that

acupuncture-being a holistic medicine- required a smile and understanding to

academic, practical and artistic qualities. I felt on the open day that all these

factors were alive and well on that day."

The reputation of a course, its content, and lecturers is always an excellent

way to be promoted. From some of these statements, there appears to be a

positive reputation within the circles of students looking for courses In TCM.

Victoria University like any other Melbourne based university has an open

day, many hundreds of prospective students attend with their friends and

families, and to get positive feedback in this way is affirming and encouraging.

There are students who have a preference to study at a government

institution.

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Hea l th Sc ience -2002 g g

"Can't find any other institution. I prefer studying in a government institution

other than private college."

"Because it offered the most complete/full on TCM course which is recognised

by the government. I was attracted to the subjects taught and opportunity

available."

From these statements, little can really be draw from them apart for the fact

that when considering courses it appears that given a choice between a

private college and a government organisation or university, the consumer will

take the university.

And those students who appeared to do little to resource their course!

"I came to VUT to study TCM because I was forced to, but since I have

started the course I am loving it, I really like this course now."

"Fate".

It cannot be assumed that there are many students who actually end up

studying such a modality because of the reasons stated above. However, with

such insight there may have been resistance from these students, which

would have possibly been misunderstood initially by staff and fellow students.

Vivienne J. Wil l iams. 3047674, Master of Health Science-2002 9 ]

CHAPTER SEVEN

7.0. CONCLUSION.

The diversity of the survey group, including cultural backgrounds, languages

spoken, religions and ages gave the research a complex flavour. Some of the

findings were unexpected considering the diversity of students. However,

when considering a course primarily with an Asian accent the expectation

may well have been that there would have been a larger Asian student body,

this was not the case. The influences which are often inflicted on students by

the families and who are young and have a strong cultural background did not

appear to sway the final decision in choosing what they wanted to study and

where.

There were no surprises in finding that the majority of students take the HECS

deferred payment option when choosing how their fees are to be paid.

However there were a surprisingly large number of students who work

throughout their studies and a significant proportion that manage to hold down

a full time job.

Overall participants felt that there should be selection interviews for the

course and more "housekeeping" type information should be given to student

about which days they are required on the campus.

When reviewing the results of the responses to questions about the teaching

and leaning section of the survey, the participants had responses, which were

not as strong as would have been expected in some areas and very strong in

other aspects. It appears that students do expect their TCM lecturers to be

currently in private practise, to have had many years of clinical experience


behind them when teaching. That they do not want their clinical teachers to be

academics but more so in practice so they can draw on current clinical

situations and experiences.

The research also showed that the participants expect their lecturers to

"practice what they preach" and to behave in a professional manner, although

they do not necessarily need to see them currently involved in research.

The acupuncture participants expected their lecturers to be up to date with

computer-based programmes whereas the herbal participants did not expect

this of their lecturers.

Participants where not particularly concerned if their lectures were politically

active, nor was it important that they were up to date with current TCM

literature. However, the majority of participants found that studying Bioscience

to be stressful but not so for TCM theory.

From these findings it can be see that TCM students are eclectic in

backgrounds but with definite views on aspects of their course. These findings

should be considered by the TCM staff at Victoria University in regards to

student's expectations of TCM lecturers and their behaviour and if necessary

staff could take steps to rectify any short falls within their own performance as

a lecturer.

As far as the areas which students find more stressful than others is

something, which is an on going issue. Discussions between the School of

Health Sciences and the Bioscience lecturers have been a part of the

landscape for many years. It would be fair to comment that considerable

changes have taken place by the Bioscience staff in the subject content and

relevance to TCM. This area appears to be an on going evolutionary process.

Vivienne J Wil l iams. 3047674. Master of Health Science-2002 9 3

This research also found that the participants showed that passion was a

great contributing factor in the study of TCIVI, which dependant on the

workload, waxed or waned, but was always present at some level.

There is a possibility that workload both internal and external to the course,

which is felt by some students to be overwhelming, contributes to this decline

in passion for their subject. This in itself maybe a cause for concern as

Victoria University moves in the direction of courses with greater "self directed

learning" or problem based learning" components. Will this effect the

reputation of the TCM course at Victoria University? Reputation was a

contributing factor for students when deciding which course to attend in TCM,

as was the breakdown of the course structure. The other university based

TCM course in Melbourne is the R.M.l.T. course, which naturally was heavily

scrutinised by Victoria University students as being too Bioscience structured.

They viewed the ability to study western Bioscience simultaneously with TCM

theory as a more appropriate option. The purpose of this research is not to

compare other university based TCM courses, however the comments made

by the participants was of such a size that it would be negligent not to mention

this fact.

Participants gave a clear picture of what their expectations were at the

completion of their course, with an increased percentage intending to practice

TCM. Perhaps what was of significance was the large number of participants

who intended to work in their own practice with another TCM practitioner. This

should be taken into account when considering teaching students in their final

year just how to go about establishing their own practice.


Finally why did students choose to study TCM at Victoria University, it

appears that deferring the HECS payment, course structure, and reputation

were of great significance to students.


CHAPTER EIGHT.

8.0. FUTURE RESEARCH.

This research covered a wide variety of areas in the TCM course at Victoria

University, and perhaps what has been exposed is that there are many areas,

which still need to be researched within the present framework of course now

in place.

It is often espoused by those in a position to create courses or change

existing ones, that it is done so for the good of the course and the students.

From this research it can be assumed that that is not always the case. What

might be considered to be important by staff at Victoria University is not

necessarily what students want or require. One recommendation, which could

be made as a result of this research, is that regular surveys of student's

expectation of the course they are enrolled into take place. Perhaps not to the

extent of this survey but maybe an annual survey on the different topics

covered by this research, so that over four to five years a comprehensive

database would be complied give information, which would assist staff when

considering course changes.

A further recommendation would be that a follow up of all graduates take

place, whereby tracking of their professional life giving feedback about how

successful these students are out in the world in their chosen careers.

Whether in fact they do establish their own practices, or if they change their

plans and work in other clinics, which clinics they found to be receptive to

TCM, what other modalities do they work with, and which ones they prefer.


8.1. EDUCATIONAL DIRECTION SPECIFIC TO TCM.

Teaching TCM in a university setting in Australia is a new and innovative

move over the last decade. It is still an evolving process, which must be

monitored regularly to ensure that the essence of Traditional Chinese

medicine is not lost between the pages of a strategic plan which looks at the

cost of training students rather than the outcome. Victoria University is in a

unique position to be able to create a truly comprehensive TCM course. In

which its graduate students are highly competent practitioners who feel that

their university, its staff and the course content are of such a high standard

that its reputation grows and a benchmark has been established in

educational excellence.

V i v i e n n e J. W i l l i ams . 3 0 4 7 6 7 4 . Mas te r of Heal th S c i e n c e - 2 0 0 2 9 7

APPENDICES A: Cover letter

Victoria University School of Health Sciences.

Project Title: Why do students choose to study Traditional Chinese Medicine at Victoria University? AN analysis of the course in TCM and its students.

Student Investigator; Vivienne Williams. Lecturer, Victoria University.

We would like to invite you to be a part of a study into TCM students at Victoria University. The project will require you to complete the attached questionnaire, which will take approximately 30 minutes to fill out. The questionnaire comprises of a number of questions about your experiences as a TCM student at Victoria University; these questions will include demographic information about yourself as well as your experiences of the TCM course.

This research project is aimed at gathering information, which will help understand why students choose Victoria University to study Traditional Chinese Medicine (TCM) and what they expect from the university when they start their course. In the questionnaire students will be asked how they perceive Victoria University as the place to study TCM and the questionnaire will also help to develop a profile of TCM students, incorporating their preferences in regard to course content, preferred qualities of lecturers and expectations.

The information will be gathered in the form of a questionnaire and students from all TCM classes will be offered a chance to participate on a voluntary basis. An independent administrative member of staff will hand the questionnaire to students wishing to participate in the research from the Faculty of Human Development who will be fully briefed on the questionnaire. When the questionnaire is completed, the participant will be asked to place their form into a plain envelope, this envelope can then be placed in the clearly signed, locked assignment box at St Albans campus. Participants will be asked not to give any identifying notes or information on the envelope and to seal it prior to placing the envelope in the box.

In the unlikely event that you become distressed by completing this questionnaire the staff member who handed out the questionnaire will contact the researcher via a mobile phone or will give you the number of student counselling services.

Participation in this project is completely voluntary and you are free to withdraw from completing the questionnaire at any time. Furthermore, participation in this study is independent of your course, and your consent or withdrawal from the study will not jeopardise you in any way. Your consent to participate in this research will be implied by the return of a completed questionnaire. Any queries about your participation in this project may be directed to the Principal Investigator, Mr Cameron Gosling on 9248 1290. If you have any queries or comments about the way you have been treated, you may contact the Secretary, University Human Research Ethics Committee, Victoria University of Technology, P O Box 14428, MCMC, Melbourne 8001. (Telephone number (03) 9688 4710)

Vivienne J. Williams. 3047674. Master of Health Science-2002 9 g

Appendix B: Survey Form.

WHY DO STUDENTS CHOOSE TO STUDY TRADITIONAL CHINESE MEDICINE AT VICTORIA UNIVERSITY? AN

ANALYSIS OF THE COURSE IN TCM AND ITS STUDENTS.

Please complete the following questions about yourself by placing a tick in the box.

1. What is your age? Gender: 2. Male • FemaleC

3. What is your postcode? D D D E

4. What is your marital status? SingleD Married D De facto _

Separated D DivorcedD Widowed

5.Who do you live with? Parents YESD NO • Partner YESD NO

Sharing YESD NO • (go to Q. 6)

Children YESD NO • (go to Q. 8)

Alone YESD NO •

6.If sharing, do you share with others of a similar age? YESD NO _

7.If sharing, do you share with your children? YESU NO

8.Do you have children? YESD NO

9.1f yes, how many If yes what are their ages

10. Do you use the on campus creche facilities? YESD NO

11.What is your cultural background?

12.Do you speak a language other than English

13.If Yes, which language(s) do you speak

14.What is your religion?

YESU NO U

15.Did you move to Melbourne to commence your training in TCM? YESD NO


16. Age of entry into course years

17. Are you a VCE Entrant? YES U NO

18. What was your entry or TER score

19. Did you complete VCE at a state school YESD NO E

20. Did you complete VCE at a private fee paying school YESD NO E

21. Did you complete VCE at a TAFE college YESD NO E 22. Have you worked in an area of health prior to commencing the

course? YES • NO • 23.If yes , what area?

24. Are you getting Austudy or any government assistance to help you study?

Y E S D NO •

25. How are you paying your HECS fees?

Up front

Deferred payment

Part payment

26. Are you working? YES • (Go to Q. 26) NO • (Go to Q 27)

27. If Yes, Full time • or part time E

28. Have you studied at a tertiary level before? YES E NO

29. If yes, did you study at a university? YES U NO 30. Which university? 31.If No, where did you study?

32.What course have you studied?

33.What is your highest level of qualification?.

Vivienne J. Wil l iams. 3047674. Master of Health Science-2002 100

34.Did you experience a TCM treatment prior to commencement of the course?

Y E S U NO

35.Does anyone in your immediate family regularly see a TCM practitioner for health reasons?

Grandparents

tAi c 3 s

Parents

Siblings

Partner

Children

36. Is anyone in your family a practitioner of TCM?

Grandparents

Parents

Siblings

Partner

Children


a ; e x a b

CJO • 3

a t E

a V OX)

B O)

C3 1/3 B

b (/I o B o WD 3 o

37.1 believe the length of time the course has

been established is important in choosing an

institution.

38.1 think that there should be a selection

interview for the TCM course.

39. I think an information session on the TCM

course after being selected and prior to commencing

the course would be helpful.

40. Knowing which days I am required

on campus was important prior to commencement

of the TCM course?

41. The duration of the TCM course influenced my

decision of institution

42.1 value being taught western medical

science and TCM theory at the same time

in the course as it enhances my understanding.

43.1 believe the facilities available to me at Victoria

University are adequate for TCM training

44. I believe the number of hours taught in the

classroom are adequate.

45.The location of the Victoria University campus was

important in making a choice of TCM courses


46. H o w important to you are the fol lowing qualities in your T C M lecturers;

a) Experience as a T C M Practitioner.

b) That lecturers are currently in clinical practice.

c ) That lectures are recently published in the area o f T C M .

d) That lecturers are up to date with current T C M literature.

e) That lecturers are up to date with computer base programmes.

f ) That lecturers are currently involved in research .

g ) That lecturers are trained as teachers.

h) That lectures are interactive.

i) That lecturers are seen to "practice what they preach"

j ) That lecturers are seen to be politically active within their profession.

k) That lecturers are professional in their role as lecturers

1) That clinical teachers are in private practice.

m) That clinical teachers are not academics.

c

o a. B

o

<1> c b o a. A

a> R E o

a ^

u o o. S

c a

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o OH

E

O

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O a S

JS OX)


<u a; L. DX) «

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47 .1 look forward to my TCM lectures.

48. My lecturers are available when I need them.

49. The course coordinator is available when I need them.

50.1 find the times of my lectures suit my lifestyle.

51.1 find learning TCM stressful

52.1 find learning Bio Science stressful.

How important are the following areas in the TCM course?

53.1 believe that the TCM theory is taught in a way that is easy for me to understand.

54. My spiritual and philosophical ideals are challenged, in the course.

55. Practical TCM classes are taught in a way that is easy for me to understand.

56. For my stage in the course, I believe that my exposure to clinical experience in the course is sufficient

Vivienne J. Wil l iams. 3047674. Master of Healtl i Science-2002 104

a< CU bX) «« in Qi

u ex a» Oi "•3 e c: u e feC "5

a cs "5 a o "5 a o

5 o a ex)

57. The clinical placements offered allow me to treat a good cross section of the population.

58. The clinical teachers are willing to share their experiences with me.

59. My passion for TCM influenced my choice of course

60. Has your passion for TCM changed since you have been studying this subject?

61.1 always feel motivated to study TCM

62. On a sliding scale how would you rate your passion for TCM?

Obsessive Strong Average Declining Non existent

63. How would you describe your passion for T C M


Please complete the following questions about your intentions after successfully completing the course.

64. When I successfully complete this course I will be setting up practice in TCM

Not likely Possibly undecided Probably Definitely

O z in Z

65. I wish to establish a practice in an existing multi modality clinic

66. If no, do you intend to practice in your own clinic

67. If you work in your own clinic will you have

other practitioners working there as well?

68. Which modalities would you prefer to work with;-

Another TCM practitioner

Chiropractor

Osteopath

Naturopath

Psychologist/Counsellor

General Practitioner

Dentist

Massage therapist

a) Other, please specify.


69. Are you an Acupuncture student? YESU NO

70. Are you a Chinese Herbal student? YESD NO L

71. Why did you choose Victoria University to study TCM

Viv ienne J. Wil l iams. 3047674. Master of Health Science-2002 107

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